Provider Demographics
NPI:1598329096
Name:BONILLA COURET, AMNERIS
Entity Type:Individual
Prefix:
First Name:AMNERIS
Middle Name:
Last Name:BONILLA COURET
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 1:3355 RICHMOND RD STE 225A
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4180
Mailing Address - Country:US
Mailing Address - Phone:216-831-1494
Mailing Address - Fax:
Practice Address - Street 1:3355 RICHMOND RD STE 225A
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4180
Practice Address - Country:US
Practice Address - Phone:216-831-1494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker