Provider Demographics
NPI:1831185628
Name:FONTS, ERNESTO E
Entity type:Individual
Prefix:DR
First Name:ERNESTO
Middle Name:E
Last Name:FONTS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 SW 92ND ST
Mailing Address - Street 2:SUITE 204A
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7397
Mailing Address - Country:US
Mailing Address - Phone:305-436-9933
Mailing Address - Fax:305-436-9944
Practice Address - Street 1:777 E 25TH ST
Practice Address - Street 2:SUITE 512
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-3825
Practice Address - Country:US
Practice Address - Phone:305-696-5007
Practice Address - Fax:305-835-8907
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME41846207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL045887200Medicaid
FL94564VMedicare ID - Type Unspecified
FL045887200Medicaid