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General NPI Number Information
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NPI Number | 1609014109
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Entity Type | Individual
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Provider Name | ROSSIE E BONEFONT MPH, RD,LND
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Gender | Female
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Dates
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Enumeration Date | 01/22/2009
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Last Update Date | 02/13/2013
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Provider Practice Location Address
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Address Line | 2285 S SEMORAN BLVD
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City | ORLANDO
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State | FL
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Zip | 32822-2703
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Country | US
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Telephone | 407-282-8200
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Fax | 407-728-2801
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Provider Business Mailing Address
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Address Line | PO BOX 616788
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City | ORLANDO
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State | FL
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Zip | 32861-6788
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Country | US
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Telephone | 407-447-7105
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Fax | 407-770-0594
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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 | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 5178
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 818
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 706357
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License Number State | IL
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