Provider Demographics
NPI:1730750860
Name:BONHOMME, MARIE ROSIE (ARNP)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:ROSIE
Last Name:BONHOMME
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 1:226 NE 31ST AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-7121
Mailing Address - Country:US
Mailing Address - Phone:786-953-9972
Mailing Address - Fax:
Practice Address - Street 1:226 NE 31ST AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-7121
Practice Address - Country:US
Practice Address - Phone:786-953-9972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11014161363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily