Individual
SARA M BODNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4300 ALTON RD, MRI BUILDING, 2ND FLOOR, MIAMI BEACH, FL 33140
(305) 674-2194
(305) 532-5241
Mailing address
4525 N RAVENSWOOD AVE, STE 201, CHICAGO, IL 60640-5201
(312) 857-8794
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
036.143570
IL
2084P0800X
Psychiatry Physician
Primary
036.143570
IL
2084P0800X
Psychiatry Physician
ME69782
FL
2084P0805X
Geriatric Psychiatry Physician
ME69782
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
377478300
—
FL
Enumeration date
06/14/2006
Last updated
11/01/2019
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