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Individual

BONIFACE U NDUBISI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2964 N STATE ROAD 7, STE 100, MARGATE, FL 33063-5755
(954) 974-5190
(954) 974-0743
Mailing address
2964 N STATE ROAD 7, STE 100, MARGATE, FL 33063-5755
(954) 974-5190
(954) 974-0743

Taxonomy

Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
ME65086
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
18916
BCBS
05
262018900
FL
Enumeration date
07/21/2005
Last updated
10/21/2009
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