Active NPI
Angelica Aurora Fonseca
- Student in an Organized Health Care Education/Training Program
- San Juan, PR
National Provider Identifier
1689384240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 2308
- Practice address
- 400 Av. Luis Munoz Rivera
San Juan, PR 00918 - Phone
- (787) 296-8460
- NPI assigned
- Dec 5, 2022
- Last updated
- Dec 5, 2022
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 2308 | PR | Primary |
Addresses
Primary practice location
400 Av. Luis Munoz Rivera
San Juan, PR 00918
Mailing address
Urb. Villa Borinquen 1346 Calle Decatur
San Juan, PR 00920
Other practice location 1
1 Ave Wall
Guaynabo, PR 00966-1649
Phone (787) 792-3725
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2308 | PR | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1670198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670198400000",
"number": "1689384240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "URB. VILLA BORINQUEN 1346 CALLE DECATUR",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 AV. LUIS MUNOZ RIVERA",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00918",
"telephone_number": "787-296-8460"
}
],
"practiceLocations": [
{
"address_1": "1 Ave Wall",
"address_purpose": "LOCATION",
"city": "Guaynabo",
"state": "PR",
"postal_code": "009661649",
"country_code": "US",
"telephone_number": "787-792-3725",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FONSECA",
"first_name": "ANGELICA",
"middle_name": "AURORA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-05",
"last_updated": "2022-12-05",
"certification_date": "2022-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "PR",
"license": "2308",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.