Provider Demographics
NPI:1023111390
Name:BUONOPANE, EDWARD JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:JOSEPH
Last Name:BUONOPANE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 GRIFFIN RD STE 130
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-4538
Mailing Address - Country:US
Mailing Address - Phone:954-987-4400
Mailing Address - Fax:954-981-6586
Practice Address - Street 1:5700 GRIFFIN RD STE 130
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-4538
Practice Address - Country:US
Practice Address - Phone:954-987-4400
Practice Address - Fax:954-981-6586
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL32379174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist