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Individual

RICARDO KONAGESKI DA FONSECA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
SA-C

Contact information

Practice address
6039 SAVANNA OAK ALY, WINDERMERE, FL 34786-7421
(407) 340-0926
Mailing address
6039 SAVANNA OAK ALY, WINDERMERE, FL 34786-7421
(407) 340-0926

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
23-464
WI

Other

Enumeration date
06/29/2023
Last updated
06/29/2023
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