Organization Active NPI

Thomas O. Bonner, PH.D., P.a.

  • Clinical Psychologist
  • Miami, FL
National Provider Identifier
1487873451
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY2826 Issued in FL
Legal business name
THOMAS O. BONNER, PH.D., P.A.
Practice address
9480 SW 77TH Ave
Miami, FL 33156-7903
Phone
(305) 595-1616
Fax
(305) 595-7272
NPI assigned
Apr 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Thomas O. Bonner, PH.D.
Title
President
Phone
(305) 595-1616

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PY2826 FL Primary

Addresses

Primary practice location

9480 SW 77TH Ave
Miami, FL 33156-7903

Mailing address

9480 SW 77TH Ave
Miami, FL 33156-7903
Phone (305) 595-1616

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487873451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9480 SW 77TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331567903",
            "telephone_number": "305-595-1616",
            "fax_number": "305-595-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9480 SW 77TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331567903",
            "telephone_number": "305-595-1616",
            "fax_number": "305-595-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS O. BONNER, PH.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BONNER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-595-1616",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY2826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.