Provider Demographics
NPI:1336565969
Name:BONAVENTURE HEALTH SERVICES INC
Entity Type:Organization
Organization Name:BONAVENTURE HEALTH SERVICES INC
Other - Org Name:BONAVENTURE HEALTH SERVICES INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:MS
Authorized Official - First Name:YVELINE
Authorized Official - Middle Name:O
Authorized Official - Last Name:BELLANDE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:305-893-5364
Mailing Address - Street 1:1175 NE 125TH ST STE 302
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-5831
Mailing Address - Country:US
Mailing Address - Phone:305-893-5364
Mailing Address - Fax:877-669-7651
Practice Address - Street 1:1065 NE 125TH ST STE 101
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-5831
Practice Address - Country:US
Practice Address - Phone:305-893-5364
Practice Address - Fax:877-669-7651
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-03-06
Last Update Date:2023-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211437313M00000X
364SH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care FacilityGroup - Multi-Specialty
No364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome HealthGroup - Multi-Specialty