| Doctor Name: | EDWIN BONILLA GONZALEZ |
| NPI Number: | 1407854649 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 11614 |
| Business Practice Address: | 39 Calle Munoz Rivera Calle Munoz Rivera 39 Aguas Buenas, PR - 007033233 |
| Business Phone Number: | 7877327424 |
| Business Fax Number: | 7877327424 |
| Mailing Address: | Po Box 4952, Po Box 4952 CAGUAS |
| State: | PR |
| Postal Code: | 007264952 |
| Phone Number: | 7877327424 |
| Fax Number: | |
| NPI Enumeration Date: | 07/12/2005 |
| NPI Last Update Date: | 01/12/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 11614 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |