Provider Demographics
NPI:1154826113
Name:BONILLA, ENGELBERT PATRICK (MD)
Entity Type:Individual
Prefix:DR
First Name:ENGELBERT
Middle Name:PATRICK
Last Name:BONILLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5400 BROKEN SOUND BLVD NW APT 207
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-3581
Mailing Address - Country:US
Mailing Address - Phone:813-505-9198
Mailing Address - Fax:
Practice Address - Street 1:770 NORTHPOINT PKWY STE 200
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-1901
Practice Address - Country:US
Practice Address - Phone:561-626-3800
Practice Address - Fax:561-624-6364
Is Sole Proprietor?:No
Enumeration Date:2018-03-29
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME156387207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology