Individual
DR. ANTONIO RAFAEL FONTANELLA LARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
37 FOX CHASE DR, ENTERPRISE, AL 36330-9339
(786) 417-1647
Mailing address
37 FOX CHASE DR, ENTERPRISE, AL 36330-9339
(786) 417-1647
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16362
PR
Other
Enumeration date
06/16/2007
Last updated
10/04/2022
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