Provider Demographics
NPI:1598098774
Name:BODI, JOSEPHINE A (NP)
Entity Type:Individual
Prefix:MRS
First Name:JOSEPHINE
Middle Name:A
Last Name:BODI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:COSTA
Other - Middle Name:A
Other - Last Name:BODI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3621 TERRAMORE DR
Mailing Address - Street 2:
Mailing Address - City:VIERA
Mailing Address - State:FL
Mailing Address - Zip Code:32940-8028
Mailing Address - Country:US
Mailing Address - Phone:216-496-9057
Mailing Address - Fax:
Practice Address - Street 1:9009 CORPORATE LAKE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-2367
Practice Address - Country:US
Practice Address - Phone:321-558-0585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-06
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9308032163WW0000X
OHCOA10890363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner