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General NPI Number Information
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NPI Number | 1811060130
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Entity Type | Individual
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Provider Name | PETER FONTANA MD
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Gender | Male
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 06/04/2021
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Provider Practice Location Address
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Address Line | 800 MEADOWS RD
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City | BOCA RATON
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State | FL
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Zip | 33486-2304
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Country | US
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Telephone | 561-955-4425
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Fax |
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Provider Business Mailing Address
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Address Line | 16881 PIERRE CIR
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City | DELRAY BEACH
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State | FL
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Zip | 33446-3692
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Country | US
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Telephone |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 230419
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME112731
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License Number State | FL
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