Organization
BONITA J DRAKE M.D, P.A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BONITA J DRAKE M.D. (OWNER)
(727) 821-0612
Entity
Organization
Contact information
Practice address
3950 3RD ST N, SAINT PETERSBURG, FL 33703-6123
(727) 821-0612
(727) 822-5507
Mailing address
3950 3RD ST N, SAINT PETERSBURG, FL 33703-6123
(727) 821-0612
(727) 822-5507
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME15815
FL
Other
Enumeration date
02/14/2012
Last updated
02/14/2012
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