Provider Demographics
NPI:1376068767
Name:FONSECA FERRER, VANESSA (MD)
Entity Type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:
Last Name:FONSECA FERRER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:STREET 5 # 204 JARDINES DE TOA ALTA
Mailing Address - Street 2:
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00954
Mailing Address - Country:US
Mailing Address - Phone:787-237-0228
Mailing Address - Fax:
Practice Address - Street 1:204 CALLE 5
Practice Address - Street 2:
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-1831
Practice Address - Country:US
Practice Address - Phone:787-237-0228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR33071390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program