| NPI | 1164177721 |
|---|---|
| Former Legal Business Name | BONITA COSMETIC LLC |
| Entity Type | Organization |
| Authorized Contact | ORIBERTO IPARRAGUIRRE GONGORA Ambr 813-931-0024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2022-02-12 |
| Last Update Date | 2022-02-12 |