Individual
DIANGIE ACOSTA BONILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4390 66TH ST N, KENNETH CITY, FL 33709-4920
(727) 513-4100
(727) 565-4979
Mailing address
4390 66TH ST N, KENNETH CITY, FL 33709-4920
(727) 513-4100
(727) 565-4979
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME159985
FL
Other
Enumeration date
10/05/2019
Last updated
06/15/2023
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