Provider Demographics
NPI:1942786454
Name:CHRISTY BONGIOVANNI AP, LLC
Entity Type:Organization
Organization Name:CHRISTY BONGIOVANNI AP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURE PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:BONGIOVANNI
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:646-492-0177
Mailing Address - Street 1:8187 ROSALIE LN
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-3495
Mailing Address - Country:US
Mailing Address - Phone:646-492-0177
Mailing Address - Fax:
Practice Address - Street 1:1011 N STATE ROAD 7 STE D
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-5184
Practice Address - Country:US
Practice Address - Phone:561-333-8353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-17
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
1073011714OtherNPI