Healthcare Provider Details

I. General information

NPI: 1972997419
Provider Name (Legal Business Name): RACHEL DANIELLE FISHER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2015
Last Update Date: 02/08/2023
Certification Date: 02/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 E PRINCETON ST STE 104
ORLANDO FL
32803-1435
US

IV. Provider business mailing address

615 E PRINCETON ST STE 104
ORLANDO FL
32803-1435
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-6920
  • Fax:
Mailing address:
  • Phone: 407-303-6920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number17965
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number4301117052
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number4301117052
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code2080H0002X
TaxonomyPediatric Hospice and Palliative Medicine Physician
License NumberME158883
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: