Provider Demographics
NPI:1487751764
Name:FIVERA CONSULTING & MANAGEMENT SERVICES CORP
Entity type:Organization
Organization Name:FIVERA CONSULTING & MANAGEMENT SERVICES CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:FIDELIS
Authorized Official - Middle Name:I
Authorized Official - Last Name:EZEWIKE
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:305-491-4536
Mailing Address - Street 1:8910 MIRAMAR PKWY
Mailing Address - Street 2:SUITE 207
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-4100
Mailing Address - Country:US
Mailing Address - Phone:305-677-2483
Mailing Address - Fax:305-407-9562
Practice Address - Street 1:17355 SW 33RD CT
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-2606
Practice Address - Country:US
Practice Address - Phone:954-442-1507
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies