Provider Demographics
NPI:1811216328
Name:BONET, ZADETTE
Entity Type:Individual
Prefix:MRS
First Name:ZADETTE
Middle Name:
Last Name:BONET
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:ST # 2 R639 K 1.3 INT ANTONIO SERRANO
Mailing Address - Street 2:PARCELAS MOREDA
Mailing Address - City:SABANA HOYOS
Mailing Address - State:PR
Mailing Address - Zip Code:00688
Mailing Address - Country:US
Mailing Address - Phone:787-397-8505
Mailing Address - Fax:
Practice Address - Street 1:HC 1 BOX 3315
Practice Address - Street 2:
Practice Address - City:BAJADERO
Practice Address - State:PR
Practice Address - Zip Code:00616-9835
Practice Address - Country:US
Practice Address - Phone:787-397-8505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3221183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2227135OtherDRIVER LICENSE