Organization
BONITA COMMUNITY HEALTH CENTER INC
Active
Other names
BONITA COMMUNITY HEALTH
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MIKE RILEY (CEO)
(239) 949-6115
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
2085R0202X
Diagnostic Radiology Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2728516 00
—
FL
01
—
274894
AVMED
FL
01
—
45737
BCBS FLORIDA
FL
01
—
925030
AETNA
FL
Enumeration date
10/12/2005
Last updated
04/03/2008
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