Grundel, Bonnie L.

Grundel, Bonnie L. is an individual health care provider with primary practice located at 369 N Main St , Crestview FL 32536-3541. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Grundel, Bonnie L. can be contacted via phone (850) 398-6963.

Contact Information

Primary practice address
369 N Main St Crestview FL 32536-3541
Phone: (850) 398-6963
Fax: (850) 398-8277
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9101053 Florida

Profile Details

NPI number 1528036696
LBN Legal business name Grundel, Bonnie L.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated Sep 8th, 2020 - about 6 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 1528036696 NPPES
Florida Other Y015K BLUE CROSS BLUE SHIELD
Florida Other 17667 BLUE CROSS BLUE SHIELD
Florida Other P986780 BLUE CROSS BLUE SHIELD
Florida MEDICAID 291926500 BLUE CROSS BLUE SHIELD
Florida Other P931666 BLUE CROSS BLUE SHIELD
Florida MEDICAID 123872 CRESTVIEW BLUE CROSS BLUE SHIELD
Florida Other P00900587 BLUE CROSS BLUE SHIELD
Florida MEDICAID 123873 SANTA ROSA BLUE CROSS BLUE SHIELD

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