| R Maurice Bonilla M D P A | |
|
905 W Platt St Tampa FL 33606-2113 | |
| (813) 254-0222 | |
| (813) 254-0204 |
| Full Name | R Maurice Bonilla M D P A |
|---|---|
| Speciality | Internal Medicine |
| Location | 905 W Platt St, Tampa, Florida |
| Authorized Official Name and Position | Carol Jeanne Bonilla (ADMINISTRATOR) |
| Authorized Official Contact | 8132540222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| R Maurice Bonilla M D P A 905 W Platt St Tampa FL 33606-2113 Ph: (813) 254-0222 | R Maurice Bonilla M D P A 905 W Platt St Tampa FL 33606-2113 Ph: (813) 254-0222 |
| NPI Number | 1588759484 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 05/28/2008 |
| Medicare PECOS PAC ID | 1759383904 |
|---|---|
| Medicare Enrollment ID | O20070416000548 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588759484 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME0046378 (Florida) | Primary |
| Provider Name | Rafael M Bonilla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659477305 PECOS PAC ID: 2961462007 Enrollment ID: I20041013001080 |
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