| Doctor Name: | DR. WANDA FONSECA |
| NPI Number: | 1396931135 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 10401 |
| Business Practice Address: | 21 Calle Onice Urb. Villa Blanca Caguas, PR - 007252065 |
| Business Phone Number: | 7877438411 |
| Business Fax Number: | |
| Mailing Address: | 21 Calle Onice, Urb. Villa Blanca CAGUAS |
| State: | PR |
| Postal Code: | 007252065 |
| Phone Number: | 7877438411 |
| Fax Number: | |
| NPI Enumeration Date: | 09/14/2007 |
| NPI Last Update Date: | 09/14/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 10401 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |