Provider Demographics
NPI:1245298215
Name:BONILLA, FRANCISCO A (MD)
Entity type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:A
Last Name:BONILLA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:79 ERDMAN WAY
Mailing Address - Street 2:STE 101
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-1805
Mailing Address - Country:US
Mailing Address - Phone:617-355-8594
Mailing Address - Fax:617-730-0310
Practice Address - Street 1:79 ERDMAN WAY
Practice Address - Street 2:STE 101
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-1805
Practice Address - Country:US
Practice Address - Phone:617-355-8594
Practice Address - Fax:617-730-0310
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2018-04-27
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Provider Licenses
StateLicense IDTaxonomies
MA77974207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAF97260Medicare UPIN