Healthcare Provider Details
I. General information
NPI: 1336539170
Provider Name (Legal Business Name): BONNIE ZONAS MD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/02/2015
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date: 01/03/2017
Reactivation Date: 11/18/2020
III. Provider practice location address
680 2ND AVE N SUITE 301
NAPLES FL
34102-5753
US
IV. Provider business mailing address
680 2ND AVE N SUITE 301
NAPLES FL
34102-5753
US
V. Phone/Fax
- Phone: 239-261-7546
- Fax: 239-261-1522
- Phone: 239-261-7546
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207NS0135X |
| Taxonomy | Procedural Dermatology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MATTHEW
WAGNER
Title or Position: OFFICE MANAGER
Credential:
Phone: 239-940-2468