Individual
MR. BENNETH ILONZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
345 HAVENDALE BLVD, AUBURNDALE, FL 33823-4513
(863) 967-7803
(863) 967-8696
Mailing address
617 DEER MOSS CT, WINTER HAVEN, FL 33880-1108
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS0022868
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106552100
—
FL
Enumeration date
02/16/2007
Last updated
09/18/2008
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