Provider Demographics
NPI:1083881726
Name:BONILLA, MARIA F (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:F
Last Name:BONILLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3033 STATE ROAD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44223-3600
Mailing Address - Country:US
Mailing Address - Phone:330-253-9727
Mailing Address - Fax:330-920-3124
Practice Address - Street 1:3033 STATE ROAD
Practice Address - Street 2:SUITE 204
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223-3600
Practice Address - Country:US
Practice Address - Phone:330-253-9727
Practice Address - Fax:330-920-3124
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.091132207R00000X
OH35091132207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine