Provider Demographics
NPI:1225006554
Name:DEAN, BONNIE MUZENIC (MD)
Entity Type:Individual
Prefix:DR
First Name:BONNIE
Middle Name:MUZENIC
Last Name:DEAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7932 W SAND LAKE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7263
Mailing Address - Country:US
Mailing Address - Phone:407-355-7759
Mailing Address - Fax:407-355-4987
Practice Address - Street 1:7932 W SAND LAKE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7263
Practice Address - Country:US
Practice Address - Phone:407-355-7759
Practice Address - Fax:407-355-4987
Is Sole Proprietor?:No
Enumeration Date:2006-03-11
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME32475207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL48957VMedicare PIN
FLD21659Medicare UPIN