Bonanno, Matthew J

Bonanno, Matthew J is an individual health care provider with primary practice located at 1295 Jacaranda Blvd , Venice FL 34292-4522. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as his primary health care specialty. Bonanno, Matthew J can be contacted via phone (941) 484-1510.

Contact Information

Primary practice address
1295 Jacaranda Blvd Venice FL 34292-4522
Phone: (941) 484-1510
Fax: (941) 484-1071
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X ME88794 Florida

Profile Details

NPI number 1679678338
LBN Legal business name Bonanno, Matthew J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2006
Last updated Jun 1st, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679678338 NPPES
Florida Other ME88794 FL MEDICAL LICENSE

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