Doctor Name: | DR. DESMOND FONJI |
NPI Number: | 1285976720 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.O |
License Number: | |
Business Practice Address: | 941 Se 1st St Belle Glade, FL - 334304353 |
Business Phone Number: | 5619966156 |
Business Fax Number: | 5614394185 |
Mailing Address: | 902 Clint Moore Rd, BOCA RATON |
State: | FL |
Postal Code: | 334872800 |
Phone Number: | 5616421000 |
Fax Number: | 5618023976 |
NPI Enumeration Date: | 03/22/2013 |
NPI Last Update Date: | 04/12/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |