Doctor Name: | DR. JOSEPH J. BONANNO |
NPI Number: | 1083619399 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | ME0023366 |
Business Practice Address: | 1026 Mar Walt Dr Fort Walton Beach, FL - 325476645 |
Business Phone Number: | 8508635294 |
Business Fax Number: | 8508641648 |
Mailing Address: | 2234 Colonial Blvd, FORT MYERS |
State: | FL |
Postal Code: | 339071412 |
Phone Number: | 2399317342 |
Fax Number: | 2399317385 |
NPI Enumeration Date: | 06/15/2005 |
NPI Last Update Date: | 09/18/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0001X |
License Number: | ME0023366 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Radiation Oncology |
Taxonomy Definition: | A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |