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NPI Code Detail

MEDICARE: DR. PEDRO ARIEL BONILLA MD

MEDICARE:  DR. PEDRO ARIEL BONILLA  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice Physician23576PR

General Provider Information

NPI Number : 1093582637
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PEDRO ARIEL BONILLA MD
Provider Business Mailing Address
First Line : PO BOX 266
Second Line :
City : HORMIGUEROS
State : PR
Zip : 00660-0266
Country : US
Telephone Number : 787-414-8914
Fax Number :
Provider Business Practice Location Address
First Line : 8 CALLE JAVILLA
Second Line :
City : SAN GERMAN
State : PR
Zip : 00683-4102
Country : US
Telephone Number : 787-414-8914
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2023
Last Update Date : 12/05/2023

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Directions to “ DR. PEDRO ARIEL BONILLA MD” Practice Location

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