Provider Demographics
NPI:1669465530
Name:FIORAMONTI, JERRY M (MD)
Entity Type:Individual
Prefix:MR
First Name:JERRY
Middle Name:M
Last Name:FIORAMONTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:8787 N SCOTTSDALE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-2338
Mailing Address - Country:US
Mailing Address - Phone:623-414-9025
Mailing Address - Fax:602-214-6149
Practice Address - Street 1:8787 N SCOTTSDALE RD STE 105A100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85253-2325
Practice Address - Country:US
Practice Address - Phone:623-414-9025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ13446207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZC99537Medicare UPIN
AZZ77736Medicare PIN