MEDICARE: MR. NOEL DAVID BONDI NP

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	363LA2100X	Acute Care Nurse Practitioner	R853227	MS
2	363LF0000X	Family Nurse Practitioner	ARNP9171626	FL

General Provider Information

NPI Number	:	1518392158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NOEL DAVID BONDI NP

Provider Business Mailing Address
First Line	:	4262 WOODBINE RD
Second Line	:
City	:	PACE
State	:	FL
Zip	:	32571-8703
Country	:	US
Telephone Number	:	850-995-4798
Fax Number	:	850-995-5776

Provider Business Practice Location Address
First Line	:	535 N WILMOT RD STE 201
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85711-2629
Country	:	US
Telephone Number	:	520-694-1234
Fax Number	:

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

Provider Enumeration Date	:	09/12/2013
Last Update Date	:	10/14/2021

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