Individual provider Active NPI

Dennis F Maza Bodee, DPM

  • Primary Podiatric Medicine Podiatrist
  • Carolina, PR
National Provider Identifier
1235390519
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
073 Issued in PR
Practice address
5859 Ave Isla Verde
Condominio Coral Beach 15
Carolina, PR 00979-5701
Phone
(787) 632-2880
NPI assigned
Jun 19, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X 073 PR Primary

Addresses

Primary practice location

5859 Ave Isla Verde
Condominio Coral Beach 15
Carolina, PR 00979-5701

Mailing address

5859 Ave Isla Verde
Condominio Coral Beach 15
Isla Verde, PR 00979
UM

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
073PRMDPrimary Podiatric Medicine Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213833600000",
    "number": "1235390519",
    "addresses": [
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "5859 AVE ISLA VERDE",
            "address_2": "CONDOMINIO CORAL BEACH 15",
            "city": "ISLA VERDE",
            "state": "PR",
            "postal_code": "00979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5859 AVE ISLA VERDE",
            "address_2": "CONDOMINIO CORAL BEACH 15",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009795701",
            "telephone_number": "787-632-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZA BODEE",
        "first_name": "DENNIS",
        "middle_name": "F",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-19",
        "last_updated": "2008-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "PR",
            "license": "073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.