BON IMAGE LLC NPI 1457622557

NPI Information

  • NPI: 1457622557
  • Provider Name: BON IMAGE LLC
  • Classification: Thoracic Surgery (Cardiothoracic Vascular Surgery) - 208G00000X
  • Entity Type: Organization
  • Address: 15439 CORTEZ BLVD
    BROOKSVILLE, FL
    ZIP 34613
  • Phone: (352) 593-4194

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NPI Details

BON IMAGE LLC is a thoracic surgery cardiothoracic vascular surgery in Brooksville, FL. The provider is a thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. BON IMAGE LLC NPI is 1457622557. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

15439 CORTEZ BLVD
BROOKSVILLE, FL
ZIP 34613-113
Phone: (352) 593-4194
Fax: (352) 593-5828

The provider's authorized official is Narendra S Sastry .
The authorized official title is Manager and has the following contact phone number (813) 786-0322.

The enumeration date for this NPI number is 1/20/2012 and was last updated on 5/5/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)ME63006FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1006434900MEDICAIDFLORIDA
2E85126MEDICARE UPINFLORIDA
3064781100MEDICAIDFLORIDA
418090WMEDICARE PINFLORIDA
5330004606MEDICARE PIN
6C95307MEDICARE UPINFLORIDA
7371150100MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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