Organization
BONITA FAMILY PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL LYNN E SWEENEY (BILLING PRESIDENT)
(727) 674-8079
Entity
Organization
Contact information
Practice address
9500 BONITA BEACH RD SE, SUITE 111, BONITA SPRINGS, FL 34135-4698
(239) 947-4100
(239) 992-4100
Mailing address
9500 BONITA BEACH RD SE, SUITE 111, BONITA SPRINGS, FL 34135-4698
(239) 947-4100
(239) 992-4100
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
05/29/2009
Last updated
05/29/2009
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