Provider Demographics
NPI:1720210206
Name:BONARIGO, BEN C (MD)
Entity Type:Individual
Prefix:DR
First Name:BEN
Middle Name:C
Last Name:BONARIGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1046 ROYAL TROON CT
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34688-6324
Mailing Address - Country:US
Mailing Address - Phone:727-946-0830
Mailing Address - Fax:
Practice Address - Street 1:1046 ROYAL TROON COURT
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34688-6324
Practice Address - Country:US
Practice Address - Phone:727-942-0498
Practice Address - Fax:727-942-0408
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-17
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 48417207U00000X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine