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General NPI Number Information
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NPI Number | 1568274652
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Entity Type | Individual
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Provider Name | REINIER GUSTAVO BONACHEA
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Gender | Male
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Dates
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Enumeration Date | 01/24/2025
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 1990 SW 27TH AVE FL 2
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City | MIAMI
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State | FL
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Zip | 33145-2547
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Country | US
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Telephone | 305-890-9691
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Fax |
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Provider Business Mailing Address
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Address Line | 13105 SW 248TH ST APT 201
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City | PRINCETON
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State | FL
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Zip | 33032-6055
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Country | US
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Telephone | 786-303-8969
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Fax |
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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 | 225A00000X
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Taxonomy Name | Music Therapist
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License Number | B520727861740
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License Number State | FL
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