Healthcare Provider Details

I. General information

NPI: 1376068767
Provider Name (Legal Business Name): VANESSA FONSECA FERRER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2017
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 CALLE 5
TOA ALTA PR
00953-1831
US

IV. Provider business mailing address

STREET 5 # 204 JARDINES DE TOA ALTA
TOA ALTA PR
00954
US

V. Phone/Fax

Practice location:
  • Phone: 787-237-0228
  • Fax:
Mailing address:
  • Phone: 787-237-0228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number21922
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number21922
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number21922
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: