Individual
MANUEL FONSECA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7270 SW 4TH ST, MIAMI, FL 33144-2608
(786) 760-4656
Mailing address
7270 SW 4TH ST, MIAMI, FL 33144-2608
(786) 760-4656
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
APRN11001196
FL
Other
Enumeration date
04/12/2019
Last updated
04/12/2019
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