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General NPI Number Information
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NPI Number | 1396848537
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Entity Type | Individual
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Provider Name | MABEL M. BONILLA M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 04/03/2020
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Provider Practice Location Address
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Address Line | EDIFICIO CENTERPLEX CARR#2 KM133.5 SUITE 307
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City | AGUADA
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State | PR
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Zip | 00602
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Country | US
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Telephone | 787-908-6888
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6676
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City | MAYAGUEZ
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State | PR
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Zip | 00681-6676
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Country | US
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Telephone | 787-908-6600
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Fax | 787-675-9228
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 16229
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License Number State | PR
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