Individual
MISS KARLA MICHELLE FONTANEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
VERDE LUZ ST. / URB. PRECIOSA, #4, GURABO, PR 00778-5163
(787) 438-6690
Mailing address
VERDE LUZ ST. / URB. PRECIOSA, #4, GURABO, PR 00778-5163
(787) 438-6690
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
18302
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18302
—
PR
Enumeration date
08/18/2011
Last updated
08/18/2011
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