Provider Demographics
NPI:1124117668
Name:BONTEMPS, SANDRA ANN (DC)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:ANN
Last Name:BONTEMPS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:649 US HIGHWAY 1
Mailing Address - Street 2:SUITE 10
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-4600
Mailing Address - Country:US
Mailing Address - Phone:561-845-2300
Mailing Address - Fax:561-881-3066
Practice Address - Street 1:649 US HIGHWAY 1
Practice Address - Street 2:SUITE 10
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-4600
Practice Address - Country:US
Practice Address - Phone:561-845-2300
Practice Address - Fax:561-881-3066
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2010-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0006933111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55360Medicare ID - Type UnspecifiedMEDICARE
FL55360AMedicare PIN