Provider Demographics
NPI:1477194827
Name:BONET-CAMACHO, ARLENE I
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:I
Last Name:BONET-CAMACHO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:EXT SIERRA LINDA
Mailing Address - Street 2:N5 CALLE LOS PINOS
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-3236
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:EXT SIERRA LINDA
Practice Address - Street 2:N5 CALLE LOS PINOS
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623-3236
Practice Address - Country:US
Practice Address - Phone:407-223-7055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-07
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA75106225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist