Individual provider Active NPI

Roselyn Bonilla, M.D.

  • Obstetrics & Gynecology Physician
  • Miami Springs, FL
National Provider Identifier
1336110139
Registry record updated Feb 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME91321 Issued in FL
Practice address
230 Park St
Miami Springs, FL 33166-4452
Phone
(305) 888-2607
Fax
(305) 888-5161
NPI assigned
Jan 30, 2006
Last updated
Feb 1, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME91321 FL Primary

Addresses

Primary practice location

230 Park St
Miami Springs, FL 33166-4452

Mailing address

230 Park St
Miami Springs, FL 33166-4452
Phone (305) 888-2607

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041018000906 FL Practitioner - Obstetrics/Gynecology 7416948286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Icahn School of Medicine at Mount Sinai, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitalmd Group Holding LLCGroup PAC ID 8921091786, 535 clinicians

Practice addresses (Care Compare)

230 Park St
Miami Springs, FL 33166-4452
Phone (305) 888-2607

3225 Aviation Ave
Suite 700
Miami, FL 33133-4741
Phone (305) 273-4641

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME91321FLMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vitalmd Group Holding LLC Obstetrics & Gynecology CurrentSince Feb 1, 2013 Accepting new patients
Weill Medical College of Cornell Obstetrics & Gynecology Past Accepting new patients
Medical Associates of South Florida, Inc. PastSince Sep 20, 2009 Accepting new patients
All Womens Healthcare Inc Obstetrics & Gynecology Past Accepting new patients

Locations

3225 Aviation Ave
Ste 700
Miami, FL 33133
Phone (305) 273-4641

230 Park St
Miami Springs, FL 33166
Phone (305) 718-9800

230 Park St
#M
Miami Springs, FL 33166

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359676800000",
    "number": "1336110139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 PARK ST",
            "city": "MIAMI SPRINGS",
            "state": "FL",
            "postal_code": "331664452",
            "telephone_number": "305-888-2607",
            "fax_number": "305-888-5161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 PARK ST",
            "city": "MIAMI SPRINGS",
            "state": "FL",
            "postal_code": "331664452",
            "telephone_number": "305-888-2607",
            "fax_number": "305-888-5161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "ROSELYN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2013-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME91321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Springs, FL

Sources for this page

Verify at the official NPI Registry.