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General NPI Number Information
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NPI Number | 1669480612
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Entity Type | Individual
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Provider Name | CARLOS A FONSECA-SALGADO MD
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Gender | Male
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 11/08/2013
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Provider Practice Location Address
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Address Line | 1503 CALLE AUGUSTO RODRIGUEZ COND ASIA SUITE 401
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City | SAN JUAN
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State | PR
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Zip | 00909
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Country | US
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Telephone | 787-998-9995
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Fax |
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Provider Business Mailing Address
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Address Line | 148 CALLE ALELI URB. SAN FRANCISCO
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City | SAN JUAN
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State | PR
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Zip | 00927-6303
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Country | US
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Telephone | 787-998-9995
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 16371
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number | 16371
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License Number State | PR
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