Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175L00000X | Homeopath | AP 1947 | FL |
NPI | 1356534416 |
---|---|
Provider Name | Dr. Bonnie Ann Heidel-Arnold |
First Address | Tampa, FL 33647-1636 |
Second Address | Tampa, FL 33647 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2007 |
Last Update Date | 06/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
12568072 | CAQH (01) | FL |