# BON IMAGE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457622557
- **Authorized official:** DR. NARENDRA S SASTRY M.D. (MANAGER)
- **Authorized official phone:** (813) 786-0322

## Contact information

- **Practice address:** 15439 CORTEZ BLVD, BROOKSVILLE, FL 34613-6113
- **Practice address phone:** (352) 593-4194
- **Practice address fax:** (352) 593-5828
- **Mailing address:** 15439 CORTEZ BLVD, BROOKSVILLE, FL 34613-6113
- **Mailing address phone:** (352) 593-4194
- **Mailing address fax:** (352) 593-5828

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | ME63006 | FL | Yes |

## Other

- **Enumeration date:** 01/20/2012
- **Last updated:** 05/05/2014