LEA BONIFACIO PENALES

SHREVEPORT, LA
NPI1003809211
Former NameLEA A BONIFACIO
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy2080N0001X Pediatrics, Neonatal-Perinatal Medicine
(Licence: LA  203321)
Additional Taxonomies2080N0001X Pediatrics, Neonatal-Perinatal Medicine
(Licence: MI  4301084897)
2080N0001X Pediatrics, Neonatal-Perinatal Medicine
(Licence: NJ  MA73968)
2080N0001X Pediatrics, Neonatal-Perinatal Medicine
(Licence: CT  40150)
Enumeration Date2005-08-24
Last Update Date2015-12-07
Business Address
-- LEA BONIFACIO PENALES MD
2520 BERT KOUNS LOOP SUITE 215
SHREVEPORT, LA 71118-3130
Phone number: 318-212-5970
Mailing Address
-- LEA BONIFACIO PENALES MD
1202 LOUISIANA AVE
SHREVEPORT, LA 71101-3910
Phone number: 318-212-8946