Individual
DEVORATH FONSECA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2720 SW 97TH AVE APT 201, MIAMI, FL 33165-2680
(786) 963-9155
(786) 963-9181
Mailing address
2720 SW 97TH AVE APT 201, MIAMI, FL 33165-2680
(786) 963-9155
(786) 963-9181
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
05/17/2024
Last updated
06/25/2024
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