MEDICARE: MERCEDES BONET

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	106S00000X	Behavior Technician	19-96770	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780225466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MERCEDES BONET

Provider Business Mailing Address
First Line	:	1505 W ROBSON ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33604-4652
Country	:	US
Telephone Number	:	813-613-2855
Fax Number	:

Provider Business Practice Location Address
First Line	:	1505 W ROBSON ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33604-4652
Country	:	US
Telephone Number	:	813-613-2855
Fax Number	:

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

Provider Enumeration Date	:	10/03/2019
Last Update Date	:	04/05/2022

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Directions to “ MERCEDES BONET ” Practice Location

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