MEDICARE: BONAVENTURE HEALTH SERVICES INC

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
1	364SH0200X	Home Health Clinical Nurse Specialist
2	313M00000X	Nursing Facility/Intermediate Care Facility	30211437	FL

General Provider Information

NPI Number	:	1336565969
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BONAVENTURE HEALTH SERVICES INC

Provider Business Mailing Address
First Line	:	1175 NE 125TH ST STE 302
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33161-5831
Country	:	US
Telephone Number	:	305-893-5364
Fax Number	:	877-669-7651

Provider Business Practice Location Address
First Line	:	1065 NE 125TH ST STE 101
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33161-5831
Country	:	US
Telephone Number	:	305-893-5364
Fax Number	:	877-669-7651

Authorized Official
Title or Position	:	ADMINISTRATION
Name	:	MS. YVELINE O BELLANDE
Credential	:	RN
Telephone Number	:	305-893-5364

Provider Enumeration Date	:	03/06/2014
Last Update Date	:	09/02/2023

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Directions to “BONAVENTURE HEALTH SERVICES INC ” Practice Location

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