Provider Demographics
NPI:1942219274
Name:FONTANET, HECTOR (MD)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:
Last Name:FONTANET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38135 MARKET SQUARE
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542
Mailing Address - Country:US
Mailing Address - Phone:813-528-4975
Mailing Address - Fax:
Practice Address - Street 1:2100 VIA BELLA BLVD
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34639-5429
Practice Address - Country:US
Practice Address - Phone:813-929-3516
Practice Address - Fax:813-355-5046
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME60282207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL055444800Medicaid
FLP00159941OtherRR MEDICARE
E82013Medicare UPIN
FL12856S - TPAMedicare PIN
FLP00159941OtherRR MEDICARE