Individual
MAURICIO FORONDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SUB IDC
Contact information
Practice address
1 WAHOO AVE BLDG 499, GROTON, CT 06349-2324
(862) 812-9757
Mailing address
1 WAHOO AVE BLDG 449, GROTON, CT 06349-2324
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
05/17/2022
Last updated
05/29/2026
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