Dr. Mario J Fonseca, M.D.
Family Medicine in South Miami, FL. Individual provider (NPI-1).
NPI number1124082003
StatusActive
Last updated in NPPESJan 5, 2015
Details
- NPI
- 1124082003
- Entity type
- Individual (NPI-1)
- Name
- Dr. Mario J Fonseca
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 17, 2006
- Last updated
- Jan 5, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 65287 | FL | Yes |
Practice location
7325 Sw 63rd AveSuite 201
South Miami, FL 33143-4811
Phone 305-669-9404 · Fax 305-669-9660
Mailing address
6630 Sw 77th TerSouth Miami, FL 33143-4634
Phone 305-669-9404 · Fax 305-669-9660
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