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NPI Code Detail

MEDICARE: MR. BONNY RAPHAEL BONAPARTE II

MEDICARE: MR. BONNY RAPHAEL BONAPARTE II
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1477955516
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BONNY RAPHAEL BONAPARTE II
Provider Business Mailing Address
First Line : 7005 ELLIS ISLAND CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89130-1121
Country : US
Telephone Number : 702-659-0803
Fax Number :
Provider Business Practice Location Address
First Line : 1722 PRIMROSE PATH
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-1918
Country : US
Telephone Number : 702-515-7117
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2014
Last Update Date : 09/19/2014

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