MIGUEL FONSECA-MORENO

ANTHEM, AZ
NPI1417724402
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: AZ  10680)
Additional Taxonomies363A00000X Physician Assistant
Enumeration Date2023-12-08
Last Update Date2024-12-02
Business Address
Mr. MIGUEL FONSECA-MORENO
42104 N VENTURE DR STE D118
ANTHEM, AZ 85086-3837
Phone number: 623-505-9880
Mailing Address
Mr. MIGUEL FONSECA-MORENO
80 W MARYLAND AVE APT 207
PHOENIX, AZ 85013-1266
Phone number: 480-686-3301
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