Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 37496 | AL |
NPI | 1073765269 |
---|---|
Provider Name | Dr. Annabelle Leah Fonseca |
First Address | Mobile, AL 36640-0480 |
Second Address | Mobile, AL 36604-1541 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2008 |
Last Update Date | 16/10/2018 |