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Provider Information for 1184710501



DR. CARLOS ANTONIO FUMERO M.D.

Gender: MALE

Individual NPI: 1184710501

Calendar Last Updated: 2016-09-12

Details

Name Value
NPI 1184710501
Enumeration Date 2006-10-04
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 5301 N HABANA AVE STE 1
TAMPA, FL 33614-6890
United States

Phone: 813-876-3636 | Fax: 813-870-0077
View Map External Link
Primary Practice Address 205 N PLANT AVE
PLANT CITY, FL 33563-4731
United States

Phone: 813-876-3636 | Fax: 813-870-0077
View Map External Link
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 207R00000X - Internal Medicine FL ME 94508
No 207RE0101X - Internal Medicine Endocrinology, Diabetes & Metabolism FL ME94508
Other Identifiers
Issuer State Number