Derek Lee Bonilla, LMT

NPI #1851054134 in Deltona, Florida

Provider Information

NPI Number: 1851054134
Entity Type: Individual
Name: Derek Lee Bonilla, LMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: LMT
Enumeration Date: Oct 14, 2021
Last Updated: Oct 14, 2021

Practice Location

Address: 1206 W WELLINGTON DR
City: Deltona
State: Florida
ZIP Code: 32725-7036
Phone: (407) 314-3351

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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