Individual provider Active NPI

Victoria Bodaj, CRNA

  • Anesthesiology Physician
  • Winter Haven, FL
National Provider Identifier
1194798876
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ARNP1782652 Issued in FL
Practice address
1802 Columbia Dr
Winter Haven, FL 33881-2748
Phone
(863) 293-3115
NPI assigned
Feb 11, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ARNP1782652 FL Primary

Addresses

Primary practice location

1802 Columbia Dr
Winter Haven, FL 33881-2748

Mailing address

1802 Columbia Dr
Winter Haven, FL 33881-2748
Phone (863) 293-3115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP1782652FLMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Anesthesia Associates LLC Anesthesiology Past Accepting new patients
Anesthesia Associates MD PA Anesthesiology Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1194798876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 COLUMBIA DR",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338812748",
            "telephone_number": "863-293-3115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 COLUMBIA DR",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338812748",
            "telephone_number": "863-293-3115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODAJ",
        "first_name": "VICTORIA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ARNP1782652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.