Provider Demographics
NPI:1194031047
Name:FIDES MANAGEMENT, INC
Entity Type:Organization
Organization Name:FIDES MANAGEMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:E
Authorized Official - Last Name:TULLOCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-840-4078
Mailing Address - Street 1:5920 LONDON LN
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-4187
Mailing Address - Country:US
Mailing Address - Phone:954-840-4078
Mailing Address - Fax:
Practice Address - Street 1:5920 LONDON LN
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-4187
Practice Address - Country:US
Practice Address - Phone:954-840-4078
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-28
Last Update Date:2010-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL231602253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care