Samantha Bonilla, APRN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

APRN9226889 Issued in FL

Practice address

4915 Ehrlich Rd
Tampa, FL 33624-2038

Phone

(813) 591-4570

Fax

(813) 591-4570

NPI assigned

Apr 27, 2016

Last updated

Feb 10, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Florida Hospital Medical Group Inc

  dba AdventHealth Medical Group

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1225034234
  Medicare reassignment NPD
• Hyper Healing

  dba Hyper Healing Medical Clinics

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • North Charleston, SC
  • NPI 1508381567

  FL

  Medicare reassignment NPD
• Florida Hospital Medical Group Inc

  dba Rothman Orthopaedics AdventHealth Medical Group at Minneola

  • Prosthetic/Orthotic Supplier
  • Minneola, FL
  • NPI 1285591545
  NPD

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

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1174978175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4915 EHRLICH RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336242038",
            "telephone_number": "813-591-4570",
            "fax_number": "813-591-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 EHRLICH RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336242038",
            "telephone_number": "813-591-4570",
            "fax_number": "813-591-4570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2424 Manatee Ave W Ste 210",
            "address_purpose": "LOCATION",
            "city": "Bradenton",
            "state": "FL",
            "postal_code": "342054954",
            "country_code": "US",
            "telephone_number": "813-591-4570",
            "fax_number": "813-441-6116",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "162 W Robertson St",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335115112",
            "country_code": "US",
            "telephone_number": "813-591-4570",
            "fax_number": "813-441-6116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "SAMANTHA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-27",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN9226889",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN9226889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Bonifacio
• Rafael M Bonilla-Marquez, M.D.
• Jaime Bonilla-Santiago, M.D.
• Nathan James Bonilla-Warford, O.D.
• Christopher Angel Bonilla, MD
• Bonita Cosmetic LLC
• Bonita Springs Edc Management LLC (Emergency Dental Care USA)
• Ebony Nicole Bonner, LMHC
• Edward Bonner
• Gary Bonner, ARNP

• Adult Health Nurse Practitioner in Tampa, FL
• Providers in Tampa, FL by specialty
• Adult Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.