Provider Demographics
NPI:1164875068
Name:LOGIE, NATALIE (MD, FRCPC)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:
Last Name:LOGIE
Suffix:
Gender:F
Credentials:MD, FRCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8540 HOMEPLACE DR
Mailing Address - Street 2:APARTMENT 1327
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-1921
Mailing Address - Country:US
Mailing Address - Phone:904-510-0070
Mailing Address - Fax:
Practice Address - Street 1:1321 NW 14TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-1673
Practice Address - Country:US
Practice Address - Phone:305-243-4210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-15
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME1334812085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program