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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
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 207R00000X - Internal Medicine FL ME 94508
No 207RE0101X - Internal Medicine Endocrinology, Diabetes & Metabolism FL ME94508