Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | APRN9283370 | FL |
N | 363LA2100X | Nurse Practitioner - Acute Care | 9283370 | FL |
NPI | 1043456437 |
---|---|
Provider Name | Ileana Bonfante |
First Address | Atlanta, GA 30384-8054 |
Second Address | Miami, FL 33176-2118 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2009 |
Last Update Date | 27/05/2021 |