Provider Demographics
NPI:1679970438
Name:ALBERT, BONNYE (ARNP)
Entity Type:Individual
Prefix:
First Name:BONNYE
Middle Name:
Last Name:ALBERT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:LAKE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33403-3598
Mailing Address - Country:US
Mailing Address - Phone:561-863-0105
Mailing Address - Fax:561-863-6779
Practice Address - Street 1:500 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:LAKE PARK
Practice Address - State:FL
Practice Address - Zip Code:33403-3598
Practice Address - Country:US
Practice Address - Phone:561-863-0105
Practice Address - Fax:561-863-6779
Is Sole Proprietor?:No
Enumeration Date:2014-11-21
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9272420363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics