Provider Demographics
NPI:1659453355
Name:BONAVENTURE HEALTH SERVICES INC
Entity Type:Organization
Organization Name:BONAVENTURE HEALTH SERVICES INC
Other - Org Name:BONAVENTURE HEALTH SERVICES INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:YVES
Authorized Official - Middle Name:O
Authorized Official - Last Name:BELLANDE
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:305-893-5364
Mailing Address - Street 1:13899 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33181-1600
Mailing Address - Country:US
Mailing Address - Phone:305-893-5364
Mailing Address - Fax:305-893-5660
Practice Address - Street 1:13899 BISCAYNE BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33181-1600
Practice Address - Country:US
Practice Address - Phone:305-893-5364
Practice Address - Fax:305-893-5660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299993852251E00000X, 251F00000X, 251G00000X, 253Z00000X
FL229458251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care