Doctor Name: | DR. ELIZABETH FONSECA |
NPI Number: | 1154640530 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D |
License Number: | 17842 |
Business Practice Address: | 52 Calle Andres Oliver Arecibo, PR - 006124330 |
Business Phone Number: | 7878785401 |
Business Fax Number: | 7878785401 |
Mailing Address: | 52 Calle Andres Oliver, ARECIBO |
State: | PR |
Postal Code: | 006124330 |
Phone Number: | 7878785401 |
Fax Number: | 7878785401 |
NPI Enumeration Date: | 05/24/2010 |
NPI Last Update Date: | 05/24/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 17842 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |