Provider Demographics
NPI:1982840468
Name:JAMES J BUONAVOLONTA MD PA
Entity Type:Organization
Organization Name:JAMES J BUONAVOLONTA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:BUONAVOLONTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-682-6603
Mailing Address - Street 1:201 8TH ST S
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-6107
Mailing Address - Country:US
Mailing Address - Phone:239-682-6603
Mailing Address - Fax:
Practice Address - Street 1:201 8TH ST S
Practice Address - Street 2:SUITE 102
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-6107
Practice Address - Country:US
Practice Address - Phone:239-682-6603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-05
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME67966174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL27271Medicare PIN
FLG11157Medicare UPIN