Provider Demographics
NPI:1922891787
Name:FONSECA CHAVIER, MARIANA ISABEL
Entity type:Individual
Prefix:
First Name:MARIANA
Middle Name:ISABEL
Last Name:FONSECA CHAVIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W8-7 CALLE TIRSO DE MOLINA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6808
Mailing Address - Country:US
Mailing Address - Phone:787-470-4984
Mailing Address - Fax:
Practice Address - Street 1:388 ZONA IND REPARADA 2
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-2347
Practice Address - Country:US
Practice Address - Phone:787-840-2575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-26
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program