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Organization
BONITA COMMUNITY HEALTH CENTER INC
Active
Organization
BONITA COMMUNITY HEALTH CENTER INC
Active
Other names
BONITA COMMUNITY HEALTH
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MIKE RILEY (CEO)
(239) 949-6115
Entity
Organization
Contact information
Practice address
3501 HEALTH CENTER BLVD, BONITA SPRINGS, FL 34135-8127
(239) 949-1050
(239) 949-6111
Mailing address
3501 HEALTH CENTER BLVD, BONITA SPRINGS, FL 34135-8127
(239) 949-1050
(239) 949-6111
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2728516 00
—
FL
01
—
274894
AVMED
FL
01
—
45737
BCBS FLORIDA
FL
01
—
925030
AETNA
FL
Enumeration date
10/12/2005
Last updated
04/03/2008
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