NPIMap

Organization Active NPI

Clinisanitas, PC

  • Family Medicine Physician
  • Bridgeport, CT
National Provider Identifier
1013395755
Registry record updated Sep 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CLINISANITAS, PC
Practice address
4543 Main St
Bridgeport, CT 06606-1818
Phone
(305) 921-7621
Fax
(305) 921-7355
NPI assigned
May 14, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Fernando Fonseca, M.D.
Title
Ceo
Phone
(305) 921-7621

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

4543 Main St
Bridgeport, CT 06606-1818

Mailing address

8400 NW 33Rd St
Suite 100
Doral, FL 33122-1937
Phone (305) 921-7621

National Provider Directory

National Provider Directory
Tax ID family
Clinisanitas PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4543 Main St
Bridgeport, CT 06606

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474588800000",
    "number": "1013395755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8400 NW 33RD ST",
            "address_2": "SUITE 100",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331221937",
            "telephone_number": "305-921-7621",
            "fax_number": "305-921-7355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4543 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066061818",
            "telephone_number": "305-921-7621",
            "fax_number": "305-921-7355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINISANITAS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-14",
        "last_updated": "2016-09-23",
        "status": "A",
        "authorized_official_last_name": "FONSECA",
        "authorized_official_first_name": "FERNANDO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "305-921-7621",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.