ADITYA REDDY BODDU (NPI# 1497917744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497917744 |
| Entity Type | Individual |
| Full Name | ADITYA REDDY BODDU |
| Practice Address |
16261 Bass Rd Ste 300 Fort Myers FL 33908-3671 |
| Mailing Address |
Po Box 2147 Fort Myers FL 33902-2147 |
| Practice Telephone | 2393436410 |
| Practice Fax Number | 2393434014 |
| Mailing Telephone | 2393436410 |
| Mailing Fax Number | 2393434014 |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2020-08-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
01068916A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 104990800 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346691409 | Aditya Vikram Boddu | Psychiatry & Neurology | 1 Hospital Drive, Ste 507, Columbia, MO 65202 | 2016-06-29 |
| Street Address |
16261 BASS RD STE 300 |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33908-3671 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174520464 | Sheldon Louis Brownstein | Internal Medicine | 16261 Bass Rd Ste 300, Fort Myers, FL 33908 | 2005-07-01 |
| 1467944116 | Clarice B Wei | Nurse Practitioner | 16261 Bass Rd Ste 300, Fort Myers, FL 33908 | 2018-05-30 |
| 1104179449 | Nicole E Charles | Nurse Practitioner | 16261 Bass Rd Ste 300, Fort Myers, FL 33908-3671 | 2012-10-24 |
| 1558621375 | Steven B Deutsch | Internal Medicine | 16261 Bass Rd Ste 300, Fort Myers, FL 33908-3671 | 2012-05-26 |
| 1205138880 | April Lynn Mccann | Nurse Practitioner | 16261 Bass Rd Ste 300, Fort Myers, FL 33908 | 2010-12-02 |
| 1073589743 | Robert D Glassman | Internal Medicine | 16261 Bass Rd Ste 300, Fort Myers, FL 33908 | 2006-02-23 |
| 1619969078 | Raymond Paul Liccini | Internal Medicine | 16261 Bass Rd Ste 300, Fort Myers, FL 33908 | 2005-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760081806 | 1 Recovery | Community/Behavioral Health | 111 Daniels Dr, Fort Myers, FL 33908 | 2020-10-20 |
| 1457916462 | Avipharm, LLC | Pharmacy | 7669 Calistoble Loop, 2nd Floor, Fort Myers, FL 33908 | 2019-05-06 |
| 1013492289 | Craig M Stein | Pharmacist | 15236 Tropic Bird Court, Fort Myers, FL 33908 | 2018-10-03 |
| 1730665167 | Kyndra Lynn Petrick | Psychiatry & Neurology | 8560 Big Mangrove Dr, Fort Myers, FL 33908 | 2018-07-18 |
| 1447757547 | Douglas L Jarrett | Nurse Practitioner | 16261 Bass Rd Suite 300, Fort Myers, FL 33908 | 2018-04-06 |
| 1447754825 | Luis Daniel Ramos | General Practice | 15590 Ocean Walk Cir Apt 201, Fort Myers, FL 33908 | 2018-03-21 |
| 1619497062 | Vanesa Paola Vaquer | Dentist | 18070 S Tamiami Trl Ste 101, Fort Myers, FL 33908 | 2017-06-26 |
| 1962859603 | Teresa Ruiz | Behavior Technician | 15081 Woodrich Bend Ct Apt 416, Fort Myers, FL 33908 | 2016-05-23 |
| 1669865721 | Elena B. Alexiev | Dentist | 18070 S. Tamiami Trail, #101, Fort Myers, FL 33908 | 2015-03-13 |
| 1134488919 | Cecelia Anne Collins | Dietitian, Registered | 9215 Calle Arragon Avenue, Unit 205, Fort Myers, FL 33908 | 2012-05-14 |
| Find all providers in zip 33908 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154882447 | Cfl Care of Fl Iv, LLC | Internal Medicine | 8831 Business Park Dr Ste 301, Fort Myers, FL 33912-2510 | 2019-03-28 |
| 1528501731 | Turalic Medical Pllc | Internal Medicine | 9160 Forum Corporate Pkwy Ste 350, Fort Myers, FL 33905-7808 | 2016-11-21 |
| 1710257431 | Victoria Kusiak | Internal Medicine | 3320 Shady Bnd, Fort Myers, FL 33905-6291 | 2012-01-11 |
| 1588745889 | Michael Robert Rubin | Internal Medicine | 1550 Barkley Circle, Fort Myers, FL 33907 | 2006-10-17 |
| 1871557082 | Michael Erick Burton | Internal Medicine | 9800 S Health Park Dr, Suite 320, Fort Myers, FL 33908-3630 | 2006-04-14 |
| 1881658086 | Edward A Palank | Internal Medicine | 9800 S Health Park Drive, Suite 320, Fort Myers, FL 33908 | 2006-04-14 |
| 1124089784 | Dennis L. Incorvati | Internal Medicine | 13340 Metro Pkwy Ste 200, Fort Myers, FL 33966-4818 | 2006-03-31 |
| 1447229596 | James F Butler | Internal Medicine | 14051 Metropolis Ave, Fort Myers, FL 33912-4330 | 2006-03-14 |
| 1225037146 | Anita M Arnold | Internal Medicine | 9800 S. Healthpark Drive, Suite 320, Fort Myers, FL 33908 | 2005-07-21 |
| 1174520464 | Sheldon Louis Brownstein | Internal Medicine | 16261 Bass Rd Ste 300, Fort Myers, FL 33908 | 2005-07-01 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33908 |
Please comment or provide details below to improve the information on ADITYA REDDY BODDU.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.