Provider Demographics
NPI:1245263516
Name:BUONO, CHRISTINE SPEER (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:SPEER
Last Name:BUONO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:ELISE
Other - Last Name:SPEER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7102 MERCADO LN
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-7646
Mailing Address - Country:US
Mailing Address - Phone:631-942-6393
Mailing Address - Fax:727-268-8435
Practice Address - Street 1:1832 GARDEN ST
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796-3200
Practice Address - Country:US
Practice Address - Phone:321-267-0008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0161997207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02841840Medicaid
NY547B01Medicare PIN
H94248Medicare UPIN