Elizabeth Pena Fonseca, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

F12190740 Issued in PR

Practice address

Atrium Park
17 C/ Regina Medina Apt. a 606
Guaynabo, PR 00969-6030

Phone

(787) 469-8817

NPI assigned

Jan 29, 2020

Last updated

Jan 30, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1114558020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ATRIUM PARK",
            "address_2": "17 C/ REGINA MEDINA APT. A 606",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009696030",
            "telephone_number": "787-469-8817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ATRIUM PARK",
            "address_2": "17 C/ REGINA MEDINA APT. A 606",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009696030",
            "telephone_number": "787-469-8817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA FONSECA",
        "first_name": "ELIZABETH",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-29",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PR",
            "license": "F12190740",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PR",
            "license": "F12190740",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Guaynabo, PR
• Providers in Guaynabo, PR by specialty
• Nurse Practitioner in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; 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.