| Brian Bonzo, | |
| 
					2080 Child St Dept 5000, Jacksonville, FL 32214-5000  | |
| (904) 542-7300 | |
| Not Available | 
| Full Name | Brian Bonzo | 
|---|---|
| Gender | Male | 
| Speciality | Nurse Anesthetist, Certified Registered | 
| Location | 2080 Child St Dept 5000, Jacksonville, Florida | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1174302806 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 163W00000X | Registered Nurse | RN49804 (Rhode Island) | Secondary | 
| 367500000X | Nurse Anesthetist, Certified Registered | RN11028851 (Florida) | Primary | 
| Entity Name | Jax Anesthesia Providers Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1245271154 PECOS PAC ID: 5698783702 Enrollment ID: O20060331000288  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Brian Bonzo, 2080 Child St Dept 5000, Jacksonville, FL 32214-5000 Ph: (904) 542-7300  | Brian Bonzo, 2080 Child St Dept 5000, Jacksonville, FL 32214-5000 Ph: (904) 542-7300  | 
Crystal Lynn, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000  | |
Lauren E Freed, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000  | |
Dr. Sarah Anne Piscitello, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1 Shircliff Way, Jacksonville, FL 32204 Phone: 904-477-5855  | |
Lindsay Michelle Putkowski, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 3625 University Blvd S, Jacksonville, FL 32216 Phone: 904-702-6111  | |
Michelle Alicia Coy, DNP Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2080 Child St Dept 5000, Jacksonville, FL 32214 Phone: 904-542-7300  | |
Kristina Schneider, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000  | |
Mr. Bruce Anthony Wilburn, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2165 Herschel St, Jacksonville, FL 32204 Phone: 904-387-1220  |