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NPI Code Detail

MEDICARE: DR. GREGORY F BONNER M.D

MEDICARE: DR. GREGORY F BONNER M.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
1174400000XSpecialistME57540FL

Other Identifiers

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

General Provider Information

NPI Number : 1932211224
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREGORY F BONNER M.D
Provider Business Mailing Address
First Line : 2021 E COMMERCIAL BLVD
Second Line : SUITE 202
City : FORT LAUDERDALE
State : FL
Zip : 33308-3763
Country : US
Telephone Number : 954-202-7850
Fax Number : 954-202-7781
Provider Business Practice Location Address
First Line : 2021 E COMMERCIAL BLVD
Second Line : SUITE 202
City : FORT LAUDERDALE
State : FL
Zip : 33308-3763
Country : US
Telephone Number : 954-202-7850
Fax Number : 954-202-7781
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 07/09/2007

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Directions to “ DR. GREGORY F BONNER M.D” Practice Location

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