Individual
OTILIA D FONSECA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3850 W FLAGLER ST, CORAL GABLES, FL 33134-1604
(305) 774-3400
Mailing address
11031 NE 6TH AVE, MIAMI, FL 33161-7182
(305) 398-6100
(305) 398-6099
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5150841
FL
Other
Enumeration date
04/02/2013
Last updated
04/02/2013
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