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General NPI Number Information
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NPI Number | 1124033972
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Entity Type | Organization
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Legal Business Name | MEDICAL DEVELOPMENT AND SUPPORT CORPORATION
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 12/11/2012
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Provider Practice Location Address
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Address Line | 803 S PARSONS AVE
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City | BRANDON
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State | FL
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Zip | 33511
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Country | US
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Telephone | 813-651-9888
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Fax | 813-654-0362
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Provider Business Mailing Address
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Address Line | 803 S PARSONS AVE
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City | BRANDON
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State | FL
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Zip | 33511
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Country | US
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Telephone | 813-651-9888
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Fax | 813-654-0362
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Authorized Official
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Title or Position | OWNER
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Name | FABIO F FIORE
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Credential | MD
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Telephone | 813-651-9888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ME0056708
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License Number State | FL
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