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General NPI Number Information
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NPI Number | 1114337789
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Entity Type | Individual
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Provider Name | MARTINE POLYCARPE BONHOMME ARNP
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Gender | Female
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Dates
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Enumeration Date | 05/05/2014
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Last Update Date | 12/27/2018
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Provider Practice Location Address
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Address Line | 16269 SW 21ST STREET
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City | MIRAMAR
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State | FL
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Zip | 33027
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Country | US
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Telephone | 954-439-4833
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Fax | 954-432-7682
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Provider Business Mailing Address
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Address Line | 6101 BLUE LAGOON DR STE 400
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City | MIAMI
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State | FL
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Zip | 33126-2051
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Country | US
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Telephone | 954-439-4833
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Fax | 954-432-7682
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2810312
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License Number State | FL
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