Individual provider Active NPI

Angel M Bonet, MD

  • General Practice Physician
  • Palatka, FL
National Provider Identifier
1700810801
Registry record updated Mar 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
14979 Issued in PR
Practice address
400 N State Road 19 Ste 48
Palatka, FL 32177-2449
Phone
(386) 329-8800
NPI assigned
Jul 11, 2006
Last updated
Mar 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 14979 PR Primary

Addresses

Primary practice location

400 N State Road 19 Ste 48
Palatka, FL 32177-2449

Mailing address

400 N State Road 19 Ste 48
Palatka, FL 32177-2449
Phone (787) 895-9999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20110310000580 TX Practitioner - General Practice 6305758053 Practice locations: San Angelo, TX

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14979PRMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1700810801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N STATE ROAD 19 STE 48",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321772449",
            "telephone_number": "787-895-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N STATE ROAD 19 STE 48",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321772449",
            "telephone_number": "386-329-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONET",
        "first_name": "ANGEL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "14979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palatka, FL

Sources for this page

Verify at the official NPI Registry.