Individual
MRS. BONNIE LOUISE EDGAR I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
3880 COLONIAL BLVD STE 2, FORT MYERS, FL 33966-1062
(239) 351-3715
(239) 351-2046
Mailing address
4412 VANDA DR, BONITA SPRINGS, FL 34134-4082
(318) 245-2497
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
Z10640
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982
—
LA
Enumeration date
05/25/2010
Last updated
11/01/2023
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