Individual
CORI-ANNE BONFILIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
907 OUTER RD STE B, ORLANDO, FL 32814-6601
(855) 832-6727
(772) 675-9100
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
(855) 832-6727
(772) 675-9100
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-51222
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021090200
—
FL
Enumeration date
03/13/2018
Last updated
12/20/2021
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