Provider Demographics
NPI:1215765714
Name:BONET, MICHAEL DANIEL
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DANIEL
Last Name:BONET
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13169 SW 189TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-3741
Mailing Address - Country:US
Mailing Address - Phone:305-924-5315
Mailing Address - Fax:
Practice Address - Street 1:7990 GEN FRANCISCO DE PAULA SANTANDER AVE
Practice Address - Street 2:
Practice Address - City:KENDALL
Practice Address - State:FL
Practice Address - Zip Code:33183
Practice Address - Country:US
Practice Address - Phone:305-741-2218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-318714106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician