Provider Demographics
NPI:1073305769
Name:FB INTEGRATED HEALTH
Entity type:Organization
Organization Name:FB INTEGRATED HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:JUAN
Authorized Official - Last Name:BONILLA-ACEVEDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-510-1223
Mailing Address - Street 1:MANSION DEL LAGO
Mailing Address - Street 2:179 CALLE GUAYABAL
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780
Mailing Address - Country:US
Mailing Address - Phone:787-510-1223
Mailing Address - Fax:
Practice Address - Street 1:11 CALLE APOLO
Practice Address - Street 2:BO SANTA CLARA
Practice Address - City:JAYUYA
Practice Address - State:PR
Practice Address - Zip Code:00664-0255
Practice Address - Country:US
Practice Address - Phone:787-510-1223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty