Individual
CARMEN BONILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3200 S UNIVERSITY DR, DAVIE, FL 33328-2018
(954) 262-7213
(954) 262-7355
Mailing address
3200 S UNIVERSITY DR, DAVIE, FL 33328-2018
(954) 262-7213
(954) 262-7355
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
TEACHING PERMIT 595
FL
Other
Enumeration date
09/21/2016
Last updated
09/21/2016
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