Provider Demographics
NPI:1952339988
Name:FUMERO, JAIME F
Entity type:Individual
Prefix:DR
First Name:JAIME
Middle Name:F
Last Name:FUMERO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1776
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-1776
Mailing Address - Country:US
Mailing Address - Phone:787-921-2050
Mailing Address - Fax:
Practice Address - Street 1:MANATI MEDICAL PLZ
Practice Address - Street 2:SUIT 102
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-5507
Practice Address - Country:US
Practice Address - Phone:787-921-2050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11978207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR21079Medicare ID - Type UnspecifiedNUM PROVEEDOR MEDICARE