Maria Flordesol Abuloc Culpa-Bondal, RN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN109284 Issued in GA

Practice address

145 Stone Brooke Dr
Gray, GA 31032-5864

Phone

(478) 986-2776

NPI assigned

Mar 13, 2013

Last updated

Jan 28, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Flor Bondal Professional name

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Certified Clinical Nurse Specialist (CNS)

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SGMP Southland, LLCGroup PAC ID 1153563770, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

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.

• SGMP Southland LLC

  • Psychiatry Physician
  • Valdosta, GA
  • NPI 1447695085
  Medicare reassignment Care Compare group NPD
• HHC St. Simons Inc

  dba Focus By the Sea

  • Psychiatric Hospital
  • St Simons Island, GA
  • NPI 1972557916
  Medicare reassignment NPD
• Choice Family Medicine, PC

  • Primary Care Clinic/Center
  • Valdosta, GA
  • NPI 1609087469
  NPD

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

{
    "created_epoch": "1363132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1548501745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 STONE BROOKE DR",
            "city": "GRAY",
            "state": "GA",
            "postal_code": "310325864",
            "telephone_number": "478-986-2776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 STONE BROOKE DR",
            "city": "GRAY",
            "state": "GA",
            "postal_code": "310325864",
            "telephone_number": "478-986-2776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "334 Tifton Eldorado Rd",
            "address_purpose": "LOCATION",
            "city": "Tifton",
            "state": "GA",
            "postal_code": "317949497",
            "country_code": "US",
            "telephone_number": "229-391-2301",
            "fax_number": "229-386-3221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CULPA-BONDAL",
        "first_name": "MARIA FLORDESOL",
        "middle_name": "ABULOC",
        "name_prefix": "Dr.",
        "credential": "RN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-13",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN109284",
            "primary": true
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN109284",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL NURSE SPECIALIST - PMHCNS",
            "identifier": "RN109284",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FLOR",
            "last_name": "BONDAL",
            "prefix": "DR.",
            "credential": "RN, PMHNP-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in Gray, GA
• Providers in Gray, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.