Antonio Rafael Fontanella Lara, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

16362 Issued in PR

Practice address

37 Fox Chase Dr
Enterprise, AL 36330-9339

Phone

(786) 417-1647

NPI assigned

Jun 16, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1181952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1952506362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 FOX CHASE DR",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363309339",
            "telephone_number": "786-417-1647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 FOX CHASE DR",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363309339",
            "telephone_number": "786-417-1647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTANELLA LARA",
        "first_name": "ANTONIO",
        "middle_name": "RAFAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-16",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "16362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Elizabeth Fleming
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• Carrie Ann Flowers, OTR/L
• James Edward Flowers, MD
• Sidney Blake Franklin
• Fred George PH.D,, P.a.
• Jill Free
• Virgil Allen Freet, MS, LPC
• Fresh Wave Dental Care

• Internal Medicine Physician in Enterprise, AL
• Providers in Enterprise, AL by specialty
• Internal Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.