NPI 1063133635

Jacob Bodway

Practitioner Anesthesiologist Assistant Miami, FL

Practice location

Address: 3663 S Miami Ave, Miami, FL 33133-4253
Phone: (305) 854-4400
Mailing address: 770 Claughton Island Dr APT 810, Miami, FL 33131-2627

Registered specialties

Anesthesiologist Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367H00000X Licence AA734 (FL)

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Registry record

NPI: 1063133635
Entity type: Individual
Sex (as registered): Male
NPI issued: 12 Sep 2022
Record last updated: 13 Sep 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.