Individual
ANA FONSECA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
28303 SW 132ND AVE, HOMESTEAD, FL 33033-7339
(786) 448-3826
Mailing address
28303 SW 132ND AVE, HOMESTEAD, FL 33033-7339
(786) 448-3826
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-67239
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022519900
—
FL
Enumeration date
11/02/2021
Last updated
11/02/2021
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