Individual provider Active NPI

Bonita S Lee, NP-C

  • Nurse Practitioner
  • Winter Haven, FL
National Provider Identifier
1407249501
Registry record updated Mar 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9235385 Issued in FL
Practice address
200 Avenue F NE
Winter Haven, FL 33881-4131
Phone
(863) 293-1121
NPI assigned
Mar 12, 2015
Last updated
Mar 12, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP9235385 FL Primary

Addresses

Primary practice location

200 Avenue F NE
Winter Haven, FL 33881-4131

Mailing address

PO Box 91543
Lakeland, FL 33804-1543
Phone (863) 670-2554

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250127000845 FL Practitioner - Nurse Practitioner 1153850706 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP9235385FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Health Services LLC CurrentSince Sep 23, 2024 Accepting new patients
Heavenly Hearts Home Care Services, LLC Current Accepting new patients
Cornerstone Health Services LLC CurrentSince Sep 23, 2024 Accepting new patients

Locations

1414 Kuhl Ave
Orlando, FL 32806
Phone (407) 464-9516

2445 Lane Park Rd
Tavares, FL 32778
Phone (866) 280-9355

200 Avenue F NE
Winter Haven, FL 33881
Phone (863) 292-4652

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1426118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426118400000",
    "number": "1407249501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 91543",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338041543",
            "telephone_number": "863-670-2554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 AVENUE F NE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814131",
            "telephone_number": "863-293-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "BONITA",
        "middle_name": "S",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-12",
        "last_updated": "2015-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9235385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.