Provider Demographics
NPI:1215979604
Name:FONTE, CARLOS ENRIQUE (MD)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:ENRIQUE
Last Name:FONTE
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 1:3201 S MARYLAND PKWY
Mailing Address - Street 2:SUITE 502
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109-2441
Mailing Address - Country:US
Mailing Address - Phone:702-733-8600
Mailing Address - Fax:702-733-0374
Practice Address - Street 1:3201 S MARYLAND PKWY
Practice Address - Street 2:SUITE 502
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-2441
Practice Address - Country:US
Practice Address - Phone:702-733-8600
Practice Address - Fax:702-733-0374
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6114207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease