MR. Miguel Fonseca-Moreno

NPI #1417724402 in Anthem, Arizona

Provider Information

NPI Number: 1417724402
Entity Type: Individual
Name: MR. Miguel Fonseca-Moreno
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Enumeration Date: Dec 8, 2023
Last Updated: Jun 17, 2025

Practice Location

Address: 42104 N VENTURE DR STE D118
City: Anthem
State: Arizona
ZIP Code: 85086-3837
Phone: (623) 505-9880

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X
Physician Assistant	363A00000X	Primary

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