Provider Demographics
NPI:1083604136
Name:FONT, JOSE F (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:F
Last Name:FONT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOSE
Other - Middle Name:F
Other - Last Name:FONT-SOTO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7100 W 20TH AVE
Mailing Address - Street 2:STE 806
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1897
Mailing Address - Country:US
Mailing Address - Phone:305-557-3212
Mailing Address - Fax:305-557-3261
Practice Address - Street 1:7100 W 20TH AVE
Practice Address - Street 2:STE 806
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1897
Practice Address - Country:US
Practice Address - Phone:305-557-3212
Practice Address - Fax:305-557-3261
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-28
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME22331208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL036268900Medicaid
FL060673100Medicaid
FL036268900Medicaid
FL78560YMedicare PIN