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Individual

DR. JUAN CARLOS FONSECA MILIAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6850 W 12TH AVE, HIALEAH, FL 33014-5114
(786) 930-3761
(786) 245-0751
Mailing address
2025 SW 84TH CT, MIAMI, FL 33155-1051
(786) 930-3761

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
022867
PR
261QP2300X
Primary Care Clinic/Center
Primary
1499
FL

Other

Enumeration date
09/05/2022
Last updated
08/02/2023
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