Individual
DR. VIVIEN S FONGUE FONGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
6200 SW 72ND ST, SUITE 602, SOUTH MIAMI, FL 33143-4828
(786) 662-0600
(786) 533-9419
Mailing address
PO BOX 100905, ATLANTA, GA 30384-0905
(786) 662-0600
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
272692
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03850373
—
NY
Enumeration date
06/26/2008
Last updated
10/28/2016
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