Bonner, Sean Douglas

Bonner, Sean Douglas is an individual health care provider with primary practice located at 17222 Hospital Blvd Ste 242 , Brooksville FL 34601-8925. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Bonner, Sean Douglas can be contacted via phone (352) 683-0007.

Contact Information

Primary practice address
17222 Hospital Blvd Ste 242 Brooksville FL 34601-8925
Phone: (352) 683-0007
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9101895 Florida

Profile Details

NPI number 1639120207
LBN Legal business name Bonner, Sean Douglas
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2006
Last updated Jan 29th, 2021 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639120207 NPPES
Florida MEDICAID 291189200

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