Individual
SAM BONGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1611 NW 12TH AVE # C300, MIAMI, FL 33136-1005
(305) 585-7037
Mailing address
1611 NW 12TH AVE # C300, MIAMI, FL 33136-1005
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME174860
FL
207LP2900X
Pain Medicine (Anesthesiology) Physician
ME174860
FL
Other
Enumeration date
04/15/2020
Last updated
10/06/2025
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