Healthcare Provider Details

I. General information

NPI: 1013420397
Provider Name (Legal Business Name): FIFER & HELIGMAN MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2017
Last Update Date: 05/12/2020
Certification Date: 05/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10201 ARCOS AVE STE 206
ESTERO FL
33928-9461
US

IV. Provider business mailing address

8350 RIVERWALK PARK BLVD STE 1
FORT MYERS FL
33919-8759
US

V. Phone/Fax

Practice location:
  • Phone: 239-992-3117
  • Fax: 239-992-7248
Mailing address:
  • Phone: 239-482-3110
  • Fax: 239-425-6913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: CHARLYNN MERCER
Title or Position: ADMINISTRATOR
Credential:
Phone: 239-482-3110