| Doctor Name: | DR. JUSTIN BONAZINCA |
| NPI Number: | 1205186475 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 27515 |
| Business Practice Address: | 5671 S Orange Ave Orlando, FL - 32809 |
| Business Phone Number: | 4078882255 |
| Business Fax Number: | |
| Mailing Address: | 15635 Expedition St., WINTER GARDEN |
| State: | FL |
| Postal Code: | 34787 |
| Phone Number: | 7723709926 |
| Fax Number: | |
| NPI Enumeration Date: | 09/14/2012 |
| NPI Last Update Date: | 09/14/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 27515 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |