Provider Demographics
NPI:1205846979
Name:BONILLA- FELIX, VIVIAN RAQUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:RAQUEL
Last Name:BONILLA- FELIX
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:CONDOMINIO DARLINGTON 1110 MUNOZ RIVERA 1007
Mailing Address - Street 2:
Mailing Address - City:RIO PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00925
Mailing Address - Country:US
Mailing Address - Phone:787-263-8184
Mailing Address - Fax:787-535-1031
Practice Address - Street 1:COND DARLINGTON 1110 MUNOZ RIVERA 1007
Practice Address - Street 2:
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00925
Practice Address - Country:US
Practice Address - Phone:787-764-1506
Practice Address - Fax:787-535-1031
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR79892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
0029513Medicare ID - Type Unspecified