Individual
BRIAN BONZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2080 CHILD ST DEPT 5000, JACKSONVILLE, FL 32214-5000
(904) 542-7300
Mailing address
2080 CHILD ST DEPT 5000, JACKSONVILLE, FL 32214-5000
(904) 542-7300
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN49804
RI
367500000X
Certified Registered Nurse Anesthetist
Primary
RN11028851
FL
Other
Enumeration date
09/22/2023
Last updated
10/10/2023
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