Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | ME 48417 | FL |
NPI | 1720210206 |
---|---|
Provider Name | Dr. Ben C Bonarigo |
First Address | Tarpon Springs, FL 34688-6324 |
Second Address | Tarpon Springs, FL 34688-6324 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2009 |
Last Update Date | 12/04/2016 |