Provider Demographics
NPI:1710933650
Name:FIORET, PHILIP W (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:W
Last Name:FIORET
Suffix:
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 1:5955 RAND BLVD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238-5160
Mailing Address - Country:US
Mailing Address - Phone:941-552-7500
Mailing Address - Fax:941-926-4883
Practice Address - Street 1:5955 RAND BLVD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-5160
Practice Address - Country:US
Practice Address - Phone:941-552-7500
Practice Address - Fax:941-926-4883
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME127475207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1710933650OtherNPI
KY64294176Medicaid
KY64294176Medicaid
FL1710933650OtherNPI
KY0595201Medicare ID - Type Unspecified
KY0688201Medicare ID - Type Unspecified
KY3312057Medicare ID - Type Unspecified
KY0658301Medicare ID - Type Unspecified
KY0595301Medicare ID - Type Unspecified