Dr. Gustavo A Fonseca
Hematologist Medical Oncology
521 N Lecanto Hwy Florida Cancer Specialists P L
Lecanto
, Florida 34461-9187
Dr. Gustavo A Fonseca
Hematologist Medical Oncology
521 N Lecanto Hwy Florida Cancer Specialists P L
Lecanto
, Florida 34461-9187
(239) 278-3350
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About
Features
Specialties
- Hematologist
- Medical Oncology
Languages spoken
- English
Location
First Address
- Dr. Gustavo A Fonseca
- 4371 Veronica S Shoemaker Blvd Attn: Credentialing
- Fort Myers, FL
- Zip : 33916-2216
- Fax : (239) 278-3350
- Phone : (239) 274-8200
Second Address
- Dr. Gustavo A Fonseca
- 521 N Lecanto Hwy Florida Cancer Specialists P L
- Lecanto, FL
- Zip : 34461-9187
- Fax : (352) 746-6333
- Phone : (352) 746-0707
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207RH0000X | Hematologist | ME57124 | FL |
| Y | 207RX0202X | Medical Oncology | ME57124 | FL |
National Provider Identifier
| NPI | 1063478766 |
|---|---|
| Provider Name | Dr. Gustavo A Fonseca |
| First Address | Fort Myers, FL 33916-2216 |
| Second Address | Lecanto, FL 34461-9187 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/04/2006 |
| Last Update Date | 10/11/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 064874400 | (05) | FL |
| E62246 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.