Provider Demographics
NPI:1700275146
Name:BONILLA, CINDY (ARNP)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:BONILLA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10788 BARQUE COURT
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498
Mailing Address - Country:US
Mailing Address - Phone:561-756-2950
Mailing Address - Fax:
Practice Address - Street 1:10788 BARQUE COURT
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33498
Practice Address - Country:US
Practice Address - Phone:561-756-2950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9206925363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily