Jorge Luis Fonseca

NPI #1457718488 in Mccordsville, Indiana

Provider Information

NPI Number: 1457718488
Entity Type: Individual
Name: Jorge Luis Fonseca
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Jan 21, 2016
Last Updated: Jan 21, 2016

Practice Location

Address: 8825 N FAWN MEADOW DR
City: Mccordsville
State: Indiana
ZIP Code: 46055-9291
Phone: (563) 663-6392

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist/Technologist - Athletic Trainer — Athletic Trainer	2255A2300X
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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