Provider Demographics
NPI:1548205362
Name:FIORE, RONALD CHARLES JR (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:CHARLES
Last Name:FIORE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 MEDICAL CENTER BLVD
Mailing Address - Street 2:SUITE S 750
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072
Mailing Address - Country:US
Mailing Address - Phone:504-340-6976
Mailing Address - Fax:504-349-6786
Practice Address - Street 1:3434 PRYTANIA ST
Practice Address - Street 2:STE 230
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115
Practice Address - Country:US
Practice Address - Phone:504-340-6976
Practice Address - Fax:504-349-6786
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0236492084N0400X
LAR#056216207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1484105Medicaid
4A933Medicare PIN
LA1484105Medicaid
H53446Medicare UPIN