Individual
MRS. CRYSTAL BONANNI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8333 N DAVIS HWY STE 601, PENSACOLA, FL 32514-6050
(850) 497-6200
Mailing address
3897 SAND DUNE CT, DESTIN, FL 32541-3209
(570) 916-0106
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-05110
NC
363A00000X
Physician Assistant
1967
TN
363A00000X
Physician Assistant
MA053074
PA
363AM0700X
Medical Physician Assistant
Primary
PA9109436
FL
Other
Enumeration date
03/15/2011
Last updated
01/05/2024
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