Doctor Name: | DR. ALDO VICENTE FONTICIELLA |
NPI Number: | 1851386833 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | ME 59402 |
Business Practice Address: | 619 W Grove St El Dorado, AR - 717304413 |
Business Phone Number: | 8708636133 |
Business Fax Number: | 8708636290 |
Mailing Address: | 619 W Grove St, EL DORADO |
State: | AR |
Postal Code: | 717304413 |
Phone Number: | 8708636133 |
Fax Number: | 8708636290 |
NPI Enumeration Date: | 09/15/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | ME 59402 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |