Healthcare Provider Details

I. General information

NPI: 1770968893
Provider Name (Legal Business Name): KARLA BONETTI ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2015
Last Update Date: 05/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 INGRAHAM AVE
HAINES CITY FL
33844
US

IV. Provider business mailing address

47 5TH ST NW
WINTER HAVEN FL
33881-4672
US

V. Phone/Fax

Practice location:
  • Phone: 863-438-6900
  • Fax: 863-547-8377
Mailing address:
  • Phone: 863-268-7850
  • Fax: 863-268-7899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberARNP9450505
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number26NJ00579000
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberARNP9450505
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: