Bonilla, Claudina A

Bonilla, Claudina A is an sole proprietor health care provider with primary practice located at 301 Memorial Medical Pkwy , Daytona Beach FL 32117-5167. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Critical Care Medicine. Allopathic & Osteopathic Physicians / Critical Care Medicine is her primary health care specialty. Bonilla, Claudina A can be contacted via phone (407) 883-0655.

Contact Information

Primary practice address
301 Memorial Medical Pkwy Daytona Beach FL 32117-5167
Phone: (407) 883-0655
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X ME0069669 Florida
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X ME069669 Florida
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 040321 Georgia

Profile Details

NPI number 1467497792
LBN Legal business name Bonilla, Claudina A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 19th, 2006
Last updated Jul 11th, 2014 - 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 1467497792 NPPES
Florida MEDICAID 379271400

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