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MR. THEODORE JOHN FONFARA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
HAS

Contact information

Practice address
2811 TAMIAMI TRL, STE.A, PORT CHARLOTTE, FL 33952-5173
(941) 629-8808
(941) 629-1025
Mailing address
2811 TAMIAMI TRL, STE.A, PORT CHARLOTTE, FL 33952-5173
(941) 629-8808
(941) 629-1025

Taxonomy

Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
AS 3621
FL

Other

Enumeration date
05/15/2013
Last updated
05/15/2013
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