Provider Demographics
NPI:1336539170
Name:BONNIE ZONAS MD
Entity Type:Organization
Organization Name:BONNIE ZONAS MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-405-1713
Mailing Address - Street 1:680 2ND AVE N
Mailing Address - Street 2:SUITE 301
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5753
Mailing Address - Country:US
Mailing Address - Phone:239-261-7546
Mailing Address - Fax:
Practice Address - Street 1:680 2ND AVE N
Practice Address - Street 2:SUITE 301
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5753
Practice Address - Country:US
Practice Address - Phone:239-261-7546
Practice Address - Fax:239-261-1522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-02
Last Update Date:2020-11-18
Deactivation Date:2017-01-03
Deactivation Code:
Reactivation Date:2020-11-18
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty