Provider Demographics
NPI:1235719782
Name:JOHN, BINI MARY (DO)
Entity type:Individual
Prefix:
First Name:BINI
Middle Name:MARY
Last Name:JOHN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:720 BROOKER CREEK BLVD STE 215
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-2937
Mailing Address - Country:US
Mailing Address - Phone:813-854-2003
Mailing Address - Fax:813-436-5378
Practice Address - Street 1:116 HARBOR VILLAGE LN
Practice Address - Street 2:
Practice Address - City:APOLLO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33572-3402
Practice Address - Country:US
Practice Address - Phone:813-493-1779
Practice Address - Fax:813-641-3821
Is Sole Proprietor?:No
Enumeration Date:2021-04-09
Last Update Date:2024-08-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS21231208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics