Organization
BONITA COMMUNITY HEALTH CENTER INC
Active
Other names
BONITA SPRINGS HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE RILEY (CEO)
(239) 949-1050
Entity
Organization
Contact information
Practice address
3501 HEALTH CENTER BLVD, BONITA SPRINGS, FL 34135-8127
(239) 949-1050
(239) 949-6111
Mailing address
3501 HEALTH CENTER BLVD, BONITA SPRINGS, FL 34135-8127
(239) 949-1050
(239) 949-6111
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1116
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
075967800
—
FL
01
—
69C
BCBS OF FLORIDA
FL
Enumeration date
10/11/2005
Last updated
03/13/2008
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