Provider Demographics
NPI:1790123560
Name:BEDELL, JOANNA LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:LEE
Last Name:BEDELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8900 SW 117TH AVE
Mailing Address - Street 2:SUITE 207B
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186
Mailing Address - Country:US
Mailing Address - Phone:305-274-6002
Mailing Address - Fax:
Practice Address - Street 1:8900 SW 117TH AVE STE 207B
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-2155
Practice Address - Country:US
Practice Address - Phone:305-274-6002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA255792207V00000X
FL132347207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology