Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | ME125797 | FL |
NPI | 1053678151 |
---|---|
Provider Name | Dr. Jonathan Paul Bonnet |
First Address | Gainesville, FL 32606-4408 |
Second Address | Gainesville, FL 32606-4401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2012 |
Last Update Date | 15/12/2016 |