Mario J Fonseca, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

65287 Issued in FL

Practice address

7325 SW 63Rd Ave
Suite 201
South Miami, FL 33143-4811

Phone

(305) 669-9404

Fax

(305) 669-9660

NPI assigned

Apr 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mario J Fonseca, MD, PA

  • Family Medicine Physician
  • South Miami, FL
  • NPI 1811287667
  Medicare reassignment NPD Authorized official
• Maria J Paricio MD PA

  • Geriatric Psychiatry Physician
  • South Miami, FL
  • NPI 1457365272
  NPD (past)

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420416000000",
    "number": "1124082003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6630 SW 77TH TER",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434634",
            "telephone_number": "305-669-9404",
            "fax_number": "305-669-9660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7325 SW 63RD AVE",
            "address_2": "SUITE 201",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434811",
            "telephone_number": "305-669-9404",
            "fax_number": "305-669-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONSECA",
        "first_name": "MARIO",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2015-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "65287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSF",
            "identifier": "23840",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "374540600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Florida Womens Healthcare
• Alexis Folgueira
• Vivien S Fongue Fongue, D.O
• Daniella Louise Fonseca, ARNP
• Doris Fonseca
• Luciel Fontelo, RDH
• Foot Ankle and Knee MRI LLC
• Forensic and Clinical Psychology Associates, P.a.
• Julie Frederickson Forero, D.O.
• Nicholas McLaury Fort, M.D.

• Family Medicine Physician in South Miami, FL
• Providers in South Miami, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.