Individual
DR. RICHARD BONNEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
11375 CORTEZ BLVD, BROOKSVILLE, FL 34613-5409
(352) 596-6632
Mailing address
11209 ELMFIELD DR, TAMPA, FL 33625-5706
18134210215
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0102207636
VA
2085R0202X
Diagnostic Radiology Physician
Primary
OS18750
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/14/2017
Last updated
05/15/2025
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