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NPI Code Detail

MEDICARE: MR. SALVATORE BONVENTRE PA-C

MEDICARE: MR. SALVATORE BONVENTRE PA-C
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
1363A00000XPhysician AssistantFL
2363A00000XPhysician AssistantPA9107778FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1427472851
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SALVATORE BONVENTRE PA-C
Provider Business Mailing Address
First Line : 5380 TECH DATA DR # 101
Second Line :
City : CLEARWATER
State : FL
Zip : 33760-3122
Country : US
Telephone Number : 800-507-8874
Fax Number :
Provider Business Practice Location Address
First Line : 3231 MCMULLEN BOOTH RD FL 34695
Second Line :
City : SAFETY HARBOR
State : FL
Zip : 34695-6607
Country : US
Telephone Number : 727-725-6008
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2014
Last Update Date : 12/04/2025

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