Bonanno, Matthew J
Bonanno, Matthew J is an individual health care provider with primary practice located at 1295 Jacaranda Blvd , Venice FL 34292-4522. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as his primary health care specialty. Bonanno, Matthew J can be contacted via phone (941) 484-1510.Contact Information
Primary practice address
1295 Jacaranda Blvd
Venice FL 34292-4522
Phone: (941) 484-1510
Fax: (941) 484-1071
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery | 2086S0122X | ME88794 | Florida |
Profile Details
| NPI number | 1679678338 |
|---|---|
| LBN Legal business name | Bonanno, Matthew J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 14th, 2006 |
| Last updated | Jun 1st, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679678338 | NPPES |
| Florida | Other | ME88794 | FL MEDICAL LICENSE |
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