Provider Demographics
NPI:1669850806
Name:FIORE, JILL RAIMATO (LMT)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:RAIMATO
Last Name:FIORE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MISS
Other - First Name:JILL
Other - Middle Name:NICOLE
Other - Last Name:RAIMATO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2307 WINEBERRY TER
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-4639
Mailing Address - Country:US
Mailing Address - Phone:410-299-7646
Mailing Address - Fax:
Practice Address - Street 1:2307 WINEBERRY TER
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-4639
Practice Address - Country:US
Practice Address - Phone:410-299-7646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-07
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM01571225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist