Provider Demographics
NPI:1831150408
Name:BONTEMPS, ERNST (MD)
Entity type:Individual
Prefix:MR
First Name:ERNST
Middle Name:
Last Name:BONTEMPS
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 1:3001 EXECUTIVE DR STE 130
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33762-5323
Mailing Address - Country:US
Mailing Address - Phone:727-349-0005
Mailing Address - Fax:727-541-6558
Practice Address - Street 1:7017 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710
Practice Address - Country:US
Practice Address - Phone:727-384-2016
Practice Address - Fax:727-343-3791
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME83742207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL09008OtherBCBS
100016262OtherRAILROAD MEDICARE
FL264350200Medicaid
FLN217005OtherWELLCARE
FL264350200Medicaid
100016262OtherRAILROAD MEDICARE
FL09008ZMedicare PIN