DR. GUSTAVO A FONSECA (NPI# 1063478766) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063478766 |
Entity Type | Individual |
Full Name | DR. GUSTAVO A FONSECA |
Credential | MD |
Practice Address |
521 N Lecanto Hwy Florida Cancer Specialists P L Lecanto FL 34461-9187 |
Mailing Address |
4371 Veronica S Shoemaker Blvd Attn: Credentialing Fort Myers FL 33916-2216 |
Practice Telephone | 3527460707 |
Practice Fax Number | 3527466333 |
Mailing Telephone | 2392748200 |
Mailing Fax Number | 2392783350 |
Enumeration Date | 2006-04-22 |
Last Update Date | 2020-06-01 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207RH0000X |
Internal Medicine Specialization: Hematology |
ME57124 | FL | Allopathic & Osteopathic Physicians |
Y | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
ME57124 | FL | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | 064874400 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780296905 | Gustavo Fonseca | Registered Nurse | 4309 3rd Ave, San Diego, CA 92103-1407 | 2020-08-19 |
Street Address |
521 N LECANTO HWY FLORIDA CANCER SPECIALISTS P L |
City | LECANTO |
State | FL |
Zip Code | 34461-9187 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437798402 | Amber Marie Albaugh | Nurse Practitioner | 521 N Lecanto Hwy, Lecanto, FL 34461-9187 | 2019-12-23 |
1053853804 | Sally Mcdonald | Nurse Practitioner | 521 N Lecanto Hwy, Lecanto, FL 34461-9187 | 2016-11-10 |
1790116697 | Jeanine M Grossman | Nurse Practitioner | 521 N Lecanto Hwy, Lecanto, FL 34461-9187 | 2013-12-03 |
1699017988 | Florida Cancer Specialists & Research Institute, LLC | Internal Medicine | 521 N Lecanto Hwy, Lecanto, FL 34461-9187 | 2013-03-25 |
1891743217 | V Upender Rao | Internal Medicine | 521 N Lecanto Hwy, Florida Cancer Specialists P L, Lecanto, FL 34461-9187 | 2006-05-05 |
1811945231 | Sunil G Gandhi | Internal Medicine | 521 N Lecanto Hwy, Florida Cancer Specialists P L, Lecanto, FL 34461-9187 | 2006-05-05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891261160 | Shekinah Barfield | Physician Assistant | Pediatric and Internal Medicine Specialist Inc, 1990 N Prospect Ave, Lecanto, FL 34461 | 2018-10-15 |
1699240887 | Medical Risk Solutions | Family Medicine | 2804 W. Marc Knighton Court Key #10, Lecanto, FL 34461 | 2018-10-04 |
1851848097 | Pedim Outreach and Specialty Clinic LLC | Family Medicine | 1982 N Prospect Ave, Lecanto, FL 34461 | 2016-09-06 |
1265776579 | Wal-mart Stores East Lp | Technician/Technologist | 1936 N. Lecanto Hwy, Lecanto, FL 34461 | 2012-11-27 |
1922306109 | Pediatric and Internal Medicine Specialists, Pa | Clinic/Center | 1980 North Prospect Avenue, Lecanto, FL 34461 | 2011-03-11 |
1942459078 | Crq Enterprises LLC | Home Health | 4214 W Gulf To Lake Hwy, Lecanto, FL 34461 | 2008-09-12 |
1548418064 | Thomas Tybeck | Counselor | 324 S Kensington Ave Ste 328, Lecanto, FL 34461 | 2008-09-09 |
1356533566 | Amanda Nicole Coppedge | Optometrist | 240 N. Lecanto Hwy., Lecanto, FL 34461 | 2007-08-11 |
1679779185 | Brashears Vital Care Corp | Pharmacy | 471 N Dacie Pt, Lecanto, FL 34461 | 2007-06-22 |
1285751099 | Interim Healthcare Private Services, Inc. | Home Health | 581 E. Gulf To Lake Highway, Village West Plaza, Lecanto, FL 34461 | 2007-03-25 |
Find all providers in zip 34461 |
Taxonomy Code | 207RX0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Medical Oncology |
An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source. 11/5/2007: corrected definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699017988 | Florida Cancer Specialists & Research Institute, LLC | Internal Medicine | 521 N Lecanto Hwy, Lecanto, FL 34461-9187 | 2013-03-25 |
1891743217 | V Upender Rao | Internal Medicine | 521 N Lecanto Hwy, Florida Cancer Specialists P L, Lecanto, FL 34461-9187 | 2006-05-05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568079648 | The Oncology Institute Fl, LLC | Internal Medicine | 2105 W Watrous Ave, Tampa, FL 33606-3046 | 2020-09-23 |
1821626383 | Tampa General Medical Group Inc | Internal Medicine | 17416 Brookside Trace Ct, Tampa, FL 33647-3589 | 2020-03-31 |
1770143752 | Raul Vera-gimon | Internal Medicine | 10730 Nw 66th St Apt 312, Doral, FL 33178-3708 | 2019-06-20 |
1740748706 | 21st Century Oncology LLC | Internal Medicine | 3651 Fau Blvd Ste 100, Boca Raton, FL 33431-6489 | 2019-03-08 |
1699243501 | Jose Armando Villamil | Internal Medicine | 8356 Sw 40th St Ste J, Miami, FL 33155-3356 | 2018-11-08 |
1790287878 | South Florida Cancer Institute | Internal Medicine | 1005 Marina Mile Blvd, Fort Lauderdale, FL 33315-2433 | 2018-03-05 |
1912350596 | Gilberto Lopes | Internal Medicine | 8345 Nw 66th St # 9886, Miami, FL 33195-2696 | 2016-07-19 |
1013382399 | Neil Howard Love | Internal Medicine | 2 S Biscayne Blvd, Ste 3600, Miami, FL 33131-1806 | 2015-12-11 |
1790115681 | Calvin Collins Jr. | Internal Medicine | 4403 Vineland Rd, Suite B5, Orlando, FL 32811 | 2013-11-14 |
1275895047 | Ira D Stein | Internal Medicine | 19 Jewfish Ave, Key Largo, FL 33037-4711 | 2012-06-08 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.