Healthcare Provider Details

I. General information

NPI: 1992971550
Provider Name (Legal Business Name): ESPERANZA ENID FONT-MONTGOMERY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ESPERANZA ENID FONT CARO M.D.

II. Dates (important events)

Enumeration Date: 05/05/2008
Last Update Date: 11/20/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 BEAUBIEN BOULEVARD
DETROIT MI
48201
US

IV. Provider business mailing address

3901 BEAUBIEN ST SUITE H
DETROIT MI
48201
US

V. Phone/Fax

Practice location:
  • Phone: 313-745-5870
  • Fax: 313-993-0390
Mailing address:
  • Phone: 313-832-9330
  • Fax: 313-993-8685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301048557
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207SG0202X
TaxonomyClinical Biochemical Genetics Physician
License Number4301048557
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: