Provider Demographics
NPI:1538475801
Name:BUCKLER, GEETHA NAMPI (MD)
Entity type:Individual
Prefix:
First Name:GEETHA
Middle Name:NAMPI
Last Name:BUCKLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GEETHA
Other - Middle Name:
Other - Last Name:NAMPIAPARAMPIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1430 NW 94TH AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-4223
Mailing Address - Country:US
Mailing Address - Phone:847-800-8592
Mailing Address - Fax:562-200-0999
Practice Address - Street 1:1035 S STATE ROAD 7 STE 209
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6136
Practice Address - Country:US
Practice Address - Phone:561-331-8800
Practice Address - Fax:561-331-8074
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-25
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1250422084P0800X, 2084P0015X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIN255Medicare PIN