Fonseca, Gustavo A

Fonseca, Gustavo A is an individual health care provider with primary practice located at 521 N Lecanto Hwy Florida Cancer Specialists P L, Lecanto FL 34461-9187. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hematology, Allopathic & Osteopathic Physicians / Medical Oncology. Allopathic & Osteopathic Physicians / Medical Oncology is his primary health care specialty. Fonseca, Gustavo A can be contacted via phone (352) 746-0707.

Contact Information

Primary practice address
521 N Lecanto Hwy Florida Cancer Specialists P L Lecanto FL 34461-9187
Phone: (352) 746-0707
Fax: (352) 746-6333
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology 207RH0000X ME57124 Florida
Allopathic & Osteopathic Physicians / Medical Oncology 207RX0202X ME57124 Florida

Profile Details

NPI number 1063478766
LBN Legal business name Fonseca, Gustavo A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 22nd, 2006
Last updated May 2nd, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063478766 NPPES
Florida MEDICAID 064874400

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