Organization
MARK ALEXANDER FONSECA ARNP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK ALEXANDER FONSECA MSN, ARNP, AGPCNP-BC (CCO)
(786) 493-6556
Entity
Organization
Contact information
Practice address
51 SW 134TH CT, MIAMI, FL 33184-1177
(786) 493-6556
Mailing address
10310 SW 142ND CT, MIAMI, FL 33186-8422
(786) 493-6556
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP9309582
FL
363LG0600X
Gerontology Nurse Practitioner
ARNP9309582
FL
Other
Enumeration date
09/20/2017
Last updated
07/21/2022
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