Individual
DR. CLAUDINA A BONILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
301 MEMORIAL MEDICAL PKWY, DAYTONA BEACH, FL 32117-5167
(407) 883-0655
Mailing address
PO BOX 547771, ORLANDO, FL 32854-7771
(407) 883-0655
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
ME069669
FL
207RP1001X
Pulmonary Disease Physician
040321
GA
207RP1001X
Pulmonary Disease Physician
ME0069669
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
379271400
—
FL
Enumeration date
06/19/2006
Last updated
07/11/2014
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