Healthcare Provider Details

I. General information

NPI: 1730453150
Provider Name (Legal Business Name): ALAN M. FISCHER, MD,PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2012
Last Update Date: 03/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9980 CENTRAL PARK BLVD N SUITE 320
BOCA RATON FL
33428-1762
US

IV. Provider business mailing address

9980 CENTRAL PARK BLVD N SUITE 320
BOCA RATON FL
33428-1762
US

V. Phone/Fax

Practice location:
  • Phone: 561-488-2900
  • Fax:
Mailing address:
  • Phone: 561-488-2900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberME43364
License Number StateFL

VIII. Authorized Official

Name: DR. ALAN M FISCHER
Title or Position: PRESIDENT
Credential: MD
Phone: 561-488-2900