Organization
FONORT.LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NUBIA FONSECA ORTIZ MD (INTERNAL MEDICINE)
(347) 571-4429
Entity
Organization
Contact information
Practice address
2300 N COMMERCE PKWY STE 113, WESTON, FL 33326-3255
(347) 571-4429
Mailing address
129 MONTCLAIRE DR, WESTON, FL 33326-3587
(347) 571-4429
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004344400
—
FL
Enumeration date
04/04/2019
Last updated
04/04/2019
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