Provider Demographics
NPI:1912441163
Name:BONET, NELSON
Entity type:Individual
Prefix:
First Name:NELSON
Middle Name:
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 1:3613 POMEROL DR
Mailing Address - Street 2:307
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-9399
Mailing Address - Country:US
Mailing Address - Phone:786-970-8062
Mailing Address - Fax:
Practice Address - Street 1:3613 POMEROL DR
Practice Address - Street 2:307
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-9399
Practice Address - Country:US
Practice Address - Phone:786-970-8062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician