Bonita Dermatology, P.a.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

BONITA DERMATOLOGY, P.A.

Practice address

9411 Fountain Medical CT Ste 100
Bonita Springs, FL 34135-4625

Phone

(239) 593-1632

NPI assigned

Jan 12, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Suzy Pope Lee, M.D.NPI 1730185133

Title

Employee

Phone

(239) 593-1632

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Suzy Lee, M.D.

  • Dermatology Physician
  • Bonita Springs, FL
  • NPI 1730185133
  Medicare reassignment NPD Authorized official
• Brian D Lee

  • Internal Medicine Physician
  • Bonita Springs, FL
  • NPI 1174521066
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1326326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329350400000",
    "number": "1073883617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9411 FOUNTAIN MEDICAL CT STE 100",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341354625",
            "telephone_number": "239-593-1632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9411 FOUNTAIN MEDICAL CT STE 100",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341354625",
            "telephone_number": "239-593-1632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONITA DERMATOLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-12",
        "last_updated": "2012-02-16",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "SUZY",
        "authorized_official_middle_name": "POPE",
        "authorized_official_title_or_position": "EMPLOYEE",
        "authorized_official_telephone_number": "239-593-1632",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonita Beach Medical Group LLC
• Bonita Community Health Center Inc
• Bonita Community Health Center Inc
• Bonita Dental Care, PA
• Bonita Dental Care,PA
• Bonita Endodontic Associates, PLLC
• Bonita Family Care, Inc
• Bonita Family Practice LLC
• Bonita Health & Healing Corp
• Bonita Medical Care Center,Inc

• Specialist in Bonita Springs, FL
• Providers in Bonita Springs, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.