Individual provider Active NPI

Elba Fontanes I, ND

  • Registered Dietitian
  • Orlando, FL
National Provider Identifier
1174906689
Registry record updated Jul 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ND 3421 Issued in FL
Practice address
832 W Central Blvd
Orlando, FL 32805-1809
Phone
(407) 836-7109
NPI assigned
Jul 1, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X ND 3421 FL Primary

Addresses

Primary practice location

832 W Central Blvd
Orlando, FL 32805-1809

Mailing address

4701 Park Eden Cir
Orlando, FL 32810-1907
Phone (407) 970-4186

Other names 1

  • Elba Maldonado Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ND 3421FLMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1174906689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 PARK EDEN CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328101907",
            "telephone_number": "407-970-4186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "832 W CENTRAL BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328051809",
            "telephone_number": "407-836-7109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTANES",
        "first_name": "ELBA",
        "name_prefix": "Ms.",
        "name_suffix": "I",
        "credential": "ND",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-01",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND 3421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELBA",
            "last_name": "MALDONADO",
            "credential": "ND",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; 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.