| Jacob Bodway, | |
|
3663 S Miami Ave, Miami, FL 33133-4253 | |
| (305) 854-4400 | |
| Not Available |
| Full Name | Jacob Bodway |
|---|---|
| Gender | Male |
| Speciality | Anesthesiologist Assistant |
| Location | 3663 S Miami Ave, Miami, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063133635 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367H00000X | Anesthesiologist Assistant | AA734 (Florida) | Primary |
| Entity Name | Sheridan Healthcorp Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629781711 PECOS PAC ID: 3173429693 Enrollment ID: O20031208000355 |
| Entity Name | Anesthesia Physician Solutions Of South Florida, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104248699 PECOS PAC ID: 4688805286 Enrollment ID: O20140325000665 |
| Mailing Address | Practice Location Address |
|---|---|
| Jacob Bodway, 770 Claughton Island Dr Apt 810, Miami, FL 33131-2627 Ph: (952) 239-1766 | Jacob Bodway, 3663 S Miami Ave, Miami, FL 33133-4253 Ph: (305) 854-4400 |
Ivette Alfonso, CAA Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 8950 N Kendall Dr, Miami, FL 33176 Phone: 786-596-3621 | |
Rudrine Angel Alexis, Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 8900 N Kendall Dr, Miami, FL 33176 Phone: 786-596-1960 | |
Jordan Shapiro, Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 8900 N Kendall Dr, Miami, FL 33176 Phone: 305-595-4510 | |
Carlos Fernando Lacayo, Anesthesiologist Assistant Medicare: Not Enrolled in Medicare Practice Location: 8900 N Kendall Dr, Miami, FL 33176 Phone: 786-596-3621 | |
Valentina Garcia, C-AA Anesthesiologist Assistant Medicare: Not Enrolled in Medicare Practice Location: 3100 Sw 62nd Ave, Miami, FL 33155 Phone: 305-666-6511 | |
Daniel Shmakov, CAA Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 8900 N Kendall Dr, Miami, FL 33176 Phone: 786-596-3621 |