MEDICARE: DR. MARIA E BONNIN-SURIS M.D.

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
1	207V00000X	Obstetrics & Gynecology Physician	16940	PR

General Provider Information

NPI Number	:	1093995086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA E BONNIN-SURIS M.D.

Provider Business Mailing Address
First Line	:	200 AVE WINSTON CHURCHILL STE 406
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926-6653
Country	:	US
Telephone Number	:	787-753-4198
Fax Number	:	787-766-2665

Provider Business Practice Location Address
First Line	:	200 AVE WINSTON CHURCHILL STE 406
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926-6653
Country	:	US
Telephone Number	:	787-753-4198
Fax Number	:	787-766-2665

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2007
Last Update Date	:	05/09/2011

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