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Individual

DR. BONNIE K WHITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1100 SAWGRASS VILLAGE DR, SUITE 100, PONTE VEDRA BEACH, FL 32082-5048
(904) 285-9355
(904) 285-7442
Mailing address
6210 SAINT ANDREWS CT, PONTE VEDRA BEACH, FL 32082-2063
(904) 273-8039

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35062590
OH
208000000X
Pediatrics Physician
ME99063
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000127390
ANTHEM
OH
05
0859110
OH
01
1006360
UNITED HEALTHCARE
OH
01
1892968001
CIGNA
OH
01
341106740029
CARESOURCE
OH
01
4211817
AETNA
OH
01
53013
QUAL CHOICE
OH
01
83307
PHCS
OH
01
OC07700
NATIONWIDE HEALTH PLANS
OH
01
R62590
SUMMA CARE
OH
Enumeration date
07/01/2005
Last updated
04/17/2013
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