Gabriella Bonomo, Md, Pa | |
500 University Blvd Suite 201 Jupiter FL 33458-2773 | |
(561) 799-3770 | |
(561) 799-3776 |
Full Name | Gabriella Bonomo, Md, Pa |
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Speciality | Internal Medicine |
Location | 500 University Blvd, Jupiter, Florida |
Authorized Official Name and Position | Gabriella Bonomo (OWNER) |
Authorized Official Contact | 5617993770 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Gabriella Bonomo, Md, Pa 500 University Blvd Suite 201 Jupiter FL 33458-2773 Ph: (561) 799-3770 | Gabriella Bonomo, Md, Pa 500 University Blvd Suite 201 Jupiter FL 33458-2773 Ph: (561) 799-3770 |
NPI Number | 1932383056 |
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Provider Enumeration Date | 12/26/2007 |
Last Update Date | 12/12/2012 |
Medicare PECOS PAC ID | 3173563160 |
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Medicare Enrollment ID | O20050510000180 |
Identifier | Type | State | Issuer |
---|---|---|---|
1932383056 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | ME86702 (Florida) | Primary |
Provider Name | Gabriella Bonomo |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1770542888 PECOS PAC ID: 2668370305 Enrollment ID: I20031219000478 |
Provider Name | Linda S Chatelier |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225216740 PECOS PAC ID: 2365577293 Enrollment ID: I20100317000950 |
Provider Name | Michele A Shockley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1023069952 PECOS PAC ID: 0143346346 Enrollment ID: I20100924000925 |
Provider Name | Katherine Jane Hnis |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1174823520 PECOS PAC ID: 9234378431 Enrollment ID: I20130619000563 |
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