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NPI Code Detail

MEDICARE: DR. ALEXANDRA BONILLA PHARM. D.

MEDICARE: DR. ALEXANDRA BONILLA PHARM. D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPS44214FL

General Provider Information

NPI Number : 1235461625
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALEXANDRA BONILLA PHARM. D.
Provider Business Mailing Address
First Line : 4912 SW 166TH AVE
Second Line :
City : MIRAMAR
State : FL
Zip : 33027-4904
Country : US
Telephone Number : 939-969-3945
Fax Number :
Provider Business Practice Location Address
First Line : 6800 W 28TH AVE
Second Line :
City : HIALEAH
State : FL
Zip : 33018-5305
Country : US
Telephone Number : 305-828-0268
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2010
Last Update Date : 02/09/2010

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