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NPI Code Detail

MEDICARE: ELIZABETH BONILLA AUD

MEDICARE:   ELIZABETH  BONILLA  AUD
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
1231H00000XAudiologist30000697NC

General Provider Information

NPI Number : 1932833936
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH BONILLA AUD
Provider Business Mailing Address
First Line : 3824 N ELM ST STE 201
Second Line :
City : GREENSBORO
State : NC
Zip : 27455-2733
Country : US
Telephone Number : 336-542-2015
Fax Number : 336-542-2017
Provider Business Practice Location Address
First Line : 3824 N ELM ST STE 201
Second Line :
City : GREENSBORO
State : NC
Zip : 27455-2733
Country : US
Telephone Number : 336-542-2015
Fax Number : 336-542-2017
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2022
Last Update Date : 07/14/2022

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Directions to “ ELIZABETH BONILLA AUD” Practice Location

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