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Organization
R MAURICE BONILLA M D P A
Active
Organization
R MAURICE BONILLA M D P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL JEANNE BONILLA M.A. (ADMINISTRATOR)
(813) 254-0222
Entity
Organization
Contact information
Practice address
905 W PLATT ST, TAMPA, FL 33606-2113
(813) 254-0222
(813) 254-0204
Mailing address
905 W PLATT ST, TAMPA, FL 33606-2113
(813) 254-0222
(813) 254-0204
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME0046378
FL
Other
Enumeration date
10/04/2006
Last updated
05/28/2008
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