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Organization
GUILLERMO A. FONSECA M.D., PA
Active
Organization
GUILLERMO A. FONSECA M.D., PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GUILLERMO ANTONIO FONSECA M.D (PRESIDENT)
(305) 223-3989
Entity
Organization
Contact information
Practice address
14750 SW 26TH ST, SUITE 212-214, MIAMI, FL 33185-5933
(305) 223-3989
Mailing address
14750 SW 26TH ST, SUITE 212-214, MIAMI, FL 33185-5933
(305) 223-3989
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME0064061
FL
Other
Enumeration date
01/16/2017
Last updated
01/16/2017
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