MEDICARE: MRS. ADA BONAU

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	183500000X	Pharmacist	14436	FL

General Provider Information

NPI Number	:	1356474324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ADA BONAU

Provider Business Mailing Address
First Line	:	321 SW 63RD CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-3143
Country	:	US
Telephone Number	:	305-261-7982
Fax Number	:

Provider Business Practice Location Address
First Line	:	1701 CORAL WAY
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33145-2728
Country	:	US
Telephone Number	:	305-856-1250
Fax Number	:	305-256-4215

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	07/08/2007

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Directions to “ MRS. ADA BONAU ” Practice Location

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