| NPI | 1255921318 |
|---|---|
| Doing Business As | BONITA BEACH MEDICAL GROUP LLC |
| Entity Type | Organization |
| Authorized Contact | BOGDAN-GABRIEL COZMUTA Manager 203-558-0836 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2021-01-22 |
| Last Update Date | 2021-01-22 |