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Individual

DR. LUIS A BONILLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
CARR #2 KM 47.7, DOCTOR'S CENTER HOSPITAL, MANATI, PR 00674
(787) 363-2744
(787) 854-3440
Mailing address
425 CARR 693, PMB 121, DORADO, PR 00646-4802
(787) 366-6445
(787) 854-3440

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
17529
PR
208600000X
Surgery Physician
MD426722
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1014293760003
PA
Enumeration date
01/17/2006
Last updated
03/08/2011
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