Fonseca, Mario J

Fonseca, Mario J is an individual health care provider with primary practice located at 7325 Sw 63Rd Ave Suite 201, South Miami FL 33143-4811. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Fonseca, Mario J can be contacted via phone (305) 669-9404.

Contact Information

Primary practice address
7325 Sw 63Rd Ave Suite 201 South Miami FL 33143-4811
Phone: (305) 669-9404
Fax: (305) 669-9660
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 65287 Florida

Profile Details

NPI number 1124082003
LBN Legal business name Fonseca, Mario J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 17th, 2006
Last updated Jan 5th, 2015 - about 9 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 1124082003 NPPES
Florida Other 23840 BCBSF
Florida MEDICAID 374540600 BCBSF

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