Healthcare Provider Details

I. General information

NPI: 1790367464
Provider Name (Legal Business Name): NICOLE MARISSA FISCHER BAPTISTA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NICOLE MARISSA FISCHER DO

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 UNDERWOOD ST
ORLANDO FL
32806-1110
US

IV. Provider business mailing address

52 UNDERWOOD ST
ORLANDO FL
32806-1110
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-5270
  • Fax: 321-842-6419
Mailing address:
  • Phone: 321-841-5270
  • Fax: 321-842-6419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS21568
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberOS21568
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: