Provider Demographics
NPI:1609628627
Name:BONTHIUS, DANIEL (MD-PHD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:BONTHIUS
Suffix:
Gender:M
Credentials:MD-PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 S FEDERAL HWY UNIT 533
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-6071
Mailing Address - Country:US
Mailing Address - Phone:319-325-9805
Mailing Address - Fax:
Practice Address - Street 1:2815 S SEACREST BLVD FL 33435
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-7969
Practice Address - Country:US
Practice Address - Phone:561-737-7733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-03
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist