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NELAYDA FONTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 962-5820
(317) 962-3916
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
02006307A
IN
2086S0127X
Trauma Surgery Physician
Primary
02006307A
IN
2086S0127X
Trauma Surgery Physician
OS007236
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10119865
RAILROAD MEDICARE
FL
01
1101198061
ANTHEM PTAN
IN
05
300055542
IN
05
379880100
FL
Enumeration date
10/07/2005
Last updated
03/07/2025
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