Organization
BONITA COSMETIC LLC
Active
Other names
Bonita cosmetic llc
Organization subpart
No
Provider details
NPI number
Authorized official
ORIBERTO IPARRAGUIRRE GONGORA APRN (AMBR)
(813) 931-0024
Entity
Organization
Contact information
Practice address
7820 N ARMENIA AVE STE B, TAMPA, FL 33604-3852
(813) 931-0024
(813) 931-0026
Mailing address
405 LOCH DEVON DR, LUTZ, FL 33548-4282
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
02/12/2022
Last updated
02/12/2022
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