Provider Demographics
NPI:1912779448
Name:BONILLA, MARIA SOL
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:SOL
Last Name:BONILLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12247 SW RIMINI WAY
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34987-5432
Mailing Address - Country:US
Mailing Address - Phone:561-601-7521
Mailing Address - Fax:
Practice Address - Street 1:12247 SW RIMINI WAY
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34987-5432
Practice Address - Country:US
Practice Address - Phone:561-601-7521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-27
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula