Dr. Manuel Antonio Fonseca, DO
Family Medicine in Florence, SC. Individual provider (NPI-1).
NPI number1790769396
StatusActive
Last updated in NPPESJan 28, 2025
Details
- NPI
- 1790769396
- Entity type
- Individual (NPI-1)
- Name
- Dr. Manuel Antonio Fonseca
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 6, 2005
- Certification date
- Jan 19, 2025
- Last updated
- Jan 28, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 0419 | SC | Yes |
Practice location
1925 Hoffmeyer RdFlorence, SC 29501-4011
Phone 843-679-4214 · Fax 843-674-5146
Mailing address
Po Box 23321New York, NY 10087-3321
Phone 843-679-4214
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