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Individual

KENNETH FONTAN JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NBC-HWC

Contact information

Practice address
1071 PLOVER AVE, MIAMI SPRINGS, FL 33166-4348
(305) 915-4933
Mailing address
1071 PLOVER AVE, MIAMI SPRINGS, FL 33166-4348

Taxonomy

Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
A-3528385

Other

Enumeration date
12/13/2022
Last updated
12/29/2022
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