Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Miguel Fonseca-Moreno

Individual provider Internal Medicine Physician · NPI 1417724402

Mr. Miguel Fonseca-Moreno is an Internal Medicine Physician in Anthem, Arizona. Licensed in Arizona. Registered with an NPI since 2023.

Licensed in
AZ
In the registry since
2023
Specialties on file
2

Practice location Address checks out

42104 N Venture Dr Ste D118
Anthem, AZ 85086-3837
Phone: (623) 505-9880
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Internal Medicine Physician Taxonomy 207R00000X · Licence 10680 (AZ)

Record details

NPI number1417724402
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 8, 2023
Last updated in NPPESJune 17, 2025
Certification dateJune 17, 2025

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