Bonilla, Eileen D

Bonilla, Eileen D is an individual health care provider with primary practice located at 3840 5Th Ave N , St Petersburg FL 33713-7521. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Bonilla, Eileen D can be contacted via phone (727) 367-2273.

Contact Information

Primary practice address
3840 5Th Ave N St Petersburg FL 33713-7521
Phone: (727) 367-2273
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X LGP2925 Maryland
Behavioral Health & Social Service Providers / Mental Health 101YM0800X PMH1313 Florida

Profile Details

NPI number 1740431857
LBN Legal business name Bonilla, Eileen D
Credentials LMHC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 7th, 2008
Last updated May 5th, 2016 - about 8 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 1740431857 NPPES
Maryland MEDICAID 816700100

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