Individual
ILEANA BONFANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8900 N KENDALL DR, 3 MAIN, MIAMI, FL 33176-2118
(786) 594-9794
Mailing address
PO BOX 198054, ATLANTA, GA 30384-8054
(786) 594-6880
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN9283370
FL
363LA2100X
Acute Care Nurse Practitioner
9283370
FL
Other
Enumeration date
01/06/2009
Last updated
05/27/2021
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