Healthcare Provider Details

I. General information

NPI: 1992749246
Provider Name (Legal Business Name): JOSEPH H FISHMAN MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 LAKEVIEW RD
CLEARWATER FL
33756-3335
US

IV. Provider business mailing address

PO BOX 25533
TAMPA FL
33622-5533
US

V. Phone/Fax

Practice location:
  • Phone: 727-461-5872
  • Fax: 727-442-1600
Mailing address:
  • Phone: 727-461-5872
  • Fax: 727-442-1600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH HOWARD FISHMAN
Title or Position: OWNER
Credential: MD
Phone: 727-461-5872