Provider Demographics
NPI:1285092817
Name:BONNIE K SANTO D.C.
Entity type:Organization
Organization Name:BONNIE K SANTO D.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:SANTO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-744-8766
Mailing Address - Street 1:1640 CYPRESS DR
Mailing Address - Street 2:UNIT B
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33469-3175
Mailing Address - Country:US
Mailing Address - Phone:561-744-8766
Mailing Address - Fax:561-744-2309
Practice Address - Street 1:1640 CYPRESS DR
Practice Address - Street 2:UNIT B
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33469-3175
Practice Address - Country:US
Practice Address - Phone:561-744-8766
Practice Address - Fax:561-744-2309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-10
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8358302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE7504Medicare PIN
FLE7504Medicare UPIN