Healthcare Provider Details

I. General information

NPI: 1295734267
Provider Name (Legal Business Name): FRED HENRY HYER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 01/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 N ORANGE AVE 105
ORLANDO FL
32804-4603
US

IV. Provider business mailing address

2501 N ORANGE AVE SUITE 105 S.
ORLANDO FL
32804-4603
US

V. Phone/Fax

Practice location:
  • Phone: 407-896-1910
  • Fax: 407-896-1847
Mailing address:
  • Phone: 407-896-1910
  • Fax: 407-896-1847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberME18071
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: