| Doctor Name: | BERTHA CARIDAD FONSECA |
| NPI Number: | 1851592729 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | ME101427 |
| Business Practice Address: | 747 Ponce De Leon Blvd Suite 411 Coral Gables, FL - 331342049 |
| Business Phone Number: | 3054444175 |
| Business Fax Number: | 3054444176 |
| Mailing Address: | 9960 Nw 116th Way, Suite 13 MEDLEY |
| State: | FL |
| Postal Code: | 331781167 |
| Phone Number: | 7869241311 |
| Fax Number: | 7869241313 |
| NPI Enumeration Date: | 05/30/2007 |
| NPI Last Update Date: | 02/24/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | ME101427 |
| 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. |