Provider Demographics
NPI:1285776096
Name:INKEL, BONNIE CAROL
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:CAROL
Last Name:INKEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9005 WOODRUN ROAD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514
Mailing Address - Country:US
Mailing Address - Phone:850-791-6636
Mailing Address - Fax:
Practice Address - Street 1:9005 WOODRUN RD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-5516
Practice Address - Country:US
Practice Address - Phone:850-791-6636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 11611225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics