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Lucia Fernanda Fontalvo-herazo, MD
Diagnostic Radiology Physician in Philadelphia, Pennsylvania
NPI 1841408879

Lucia Fernanda Fontalvo-herazo is a Diagnostic Radiology Physician based in Philadelphia, PA and is specialized in Diagnostic Radiology. Lucia Fernanda Fontalvo-herazo practices in Philadelphia, PA and has the professional credentials of MD. The NPI Number for Lucia Fernanda Fontalvo-herazo is 1841408879 and holds a License No. LT000622 (Pennsylvania).

The current practice location address for Lucia Fernanda Fontalvo-herazo is 34Th Street And Civic Center Blvd, Philadelphia, PA and can be reached out via phone at 215-590-2575 and via fax at 215-590-5797.

Location: 34Th Street And Civic Center Blvd, Philadelphia, PA, 19145-2304
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1841408879
Provider Name
Lucia Fernanda Fontalvo-herazo
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
34Th Street And Civic Center Blvd, Philadelphia, PA, 19145-2304
Phone Number
215-590-2575
Fax Number
215-590-5797
Provider Enumeration Date
05/21/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
PENDING 05 PA
institution
Provider Business Practice Location Address Details
Address
34Th Street And Civic Center Blvd
City
Philadelphia
State
Pennsylvania
Zip
19104-6503
Phone Number
215-590-2575
Fax Number
215-590-5797
person
Provider Business Mailing Address Details
Address
34Th Street And Civic Center Blvd
City
Philadelphia
State
Pennsylvania
Zip
19104-6503
Phone Number
215-590-2575
Fax Number
215-590-5797
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
2085R0202X
License No.
LT000622 (Pennsylvania)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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