Provider Demographics
NPI:1841737236
Name:MONGE BONILLA, MARIA CECILIA (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:MARIA CECILIA
Middle Name:
Last Name:MONGE BONILLA
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 METROS ESTE DEL AMPM
Mailing Address - Street 2:GUACHIPELIN ESCAZU
Mailing Address - City:SAN JOSE
Mailing Address - State:SAN JOSE
Mailing Address - Zip Code:1000
Mailing Address - Country:CR
Mailing Address - Phone:5068-303-4181
Mailing Address - Fax:
Practice Address - Street 1:200 METROS ESTE DEL AMPM
Practice Address - Street 2:GUACHIPELIN ESCAZU
Practice Address - City:SAN JOSE
Practice Address - State:SAN JOSE
Practice Address - Zip Code:1000
Practice Address - Country:CR
Practice Address - Phone:5068-303-4181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZMED6772207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine