Organization
BONAVITA GROUP HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA ULLOA MSN.ED, RN (OWNER)
(305) 299-9191
Entity
Organization
Contact information
Practice address
4270 SW 97TH CT, MIAMI, FL 33165-5149
(305) 299-9191
Mailing address
4270 SW 97TH CT, MIAMI, FL 33165-5149
(305) 299-9191
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
—
—
Other
Enumeration date
04/29/2026
Last updated
04/29/2026
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