Guillermo Antonio Fonseca, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME0064061 Issued in FL

Practice address

11880 SW 40TH St
Suite 318
Miami, FL 33175-3584

Phone

(305) 223-3989

Fax

(305) 223-0145

NPI assigned

Jun 27, 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 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

General Practice

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Waterway Med Group LLCGroup PAC ID 2163894064, 3 clinicians

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.

• Waterway Med Group LLC

  • Family Medicine Physician
  • Miami, FL
  • NPI 1952027104
  Medicare reassignment Care Compare group NPD
• Fuerza Vital Medical Institute, Corp

  • Behavior Analyst
  • Miami, FL
  • NPI 1083113054
  Medicare reassignment NPD
• Miami Lakes Doctor'S LLC

  • Internal Medicine Physician
  • Miami Lakes, FL
  • NPI 1619588324
  Medicare reassignment NPD

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972700714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11880 SW 40TH ST",
            "address_2": "SUITE 318",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753584",
            "telephone_number": "305-223-3989",
            "fax_number": "305-223-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11880 SW 40TH ST",
            "address_2": "SUITE 318",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753584",
            "telephone_number": "305-223-3989",
            "fax_number": "305-223-0145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONSECA",
        "first_name": "GUILLERMO",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0064061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ana Ivonne Fonseca, NP
• Caridad Fonseca
• Daniel Alberto Fonseca Sr.
• Denisis M Fonseca
• Devorath Fonseca
• Inalvys Fonseca, OTR
• Irene Fonseca
• Isis M Fonseca
• Jesus R Fonseca, M.A
• Joanna Fonseca

• Family Medicine Physician in Miami, FL
• Providers in 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 Jul 8, 2007; 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.