Active NPI
Wanda Fonseca, M.D.
- General Practice Physician
- Caguas, PR
National Provider Identifier
1396931135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 10401
- Practice address
- 21 Calle Onice
Urb. Villa Blanca
Caguas, PR 00725-2065 - Phone
- (787) 743-8411
- NPI assigned
- Sep 14, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 10401 | PR | Primary |
Addresses
Primary practice location
21 Calle Onice
Urb. Villa Blanca
Caguas, PR 00725-2065
Mailing address
21 Calle Onice
Urb. Villa Blanca
Caguas, PR 00725-2065
Phone (787) 743-8411
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10401 | PR | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189728000000",
"number": "1396931135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 CALLE ONICE",
"address_2": "URB. VILLA BLANCA",
"city": "CAGUAS",
"state": "PR",
"postal_code": "007252065",
"telephone_number": "787-743-8411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 CALLE ONICE",
"address_2": "URB. VILLA BLANCA",
"city": "CAGUAS",
"state": "PR",
"postal_code": "007252065",
"telephone_number": "787-743-8411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONSECA",
"first_name": "WANDA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-14",
"last_updated": "2007-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "10401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Caguas, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.