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General NPI Number Information
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NPI Number | 1710166384
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Entity Type | Organization
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Legal Business Name | CLAUDINA A BONILLA MD FCCP PA
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Dates
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Enumeration Date | 10/30/2007
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Last Update Date | 01/27/2010
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Provider Practice Location Address
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Address Line | 1840 MEASE DR SUITE # 405
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City | SAFETY HARBOR
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State | FL
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Zip | 34695-6602
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Country | US
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Telephone | 727-724-9395
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Fax | 727-724-9626
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Provider Business Mailing Address
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Address Line | 1840 MEASE DR SUITE # 405
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City | SAFETY HARBOR
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State | FL
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Zip | 34695-6602
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Country | US
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Telephone | 727-724-9395
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Fax | 727-724-9626
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CLAUDIA BONILLA
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Credential | MD
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Telephone | 727-724-9395
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | ME0069669
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License Number State | FL
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