MEDICARE: DR. STEPHEN F. FIERRO DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	CH8750	FL
2	111N00000X	Chiropractor	CH8750	FL

General Provider Information

NPI Number	:	1366496135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN F. FIERRO DC

Provider Business Mailing Address
First Line	:	5191 FIRST COAST TECH PKWY
Second Line	:	3RD FLOOR
City	:	JACKSONVILLE
State	:	FL
Zip	:	32224-0609
Country	:	US
Telephone Number	:	904-223-3321
Fax Number	:	904-223-2169

Provider Business Practice Location Address
First Line	:	10475 CENTURION PKWY N STE 304
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-5004
Country	:	US
Telephone Number	:	904-270-2673
Fax Number	:	904-212-0024

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	09/28/2022

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Directions to “ DR. STEPHEN F. FIERRO DC” Practice Location

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