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General NPI Number Information
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NPI Number | 1164769980
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Entity Type | Individual
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Provider Name | CHRISTOPHER FISHER
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Gender | Male
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Dates
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Enumeration Date | 01/14/2013
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Last Update Date | 01/14/2013
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Provider Practice Location Address
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Address Line | 3800 NORTH RD 98 STE 500
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City | LAKELAND
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State | FL
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Zip | 33809
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Country | US
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Telephone | 863-859-8250
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Fax | 863-816-0005
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Provider Business Mailing Address
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Address Line | PO BOX 531027
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City | ST PETERSBURG
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State | FL
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Zip | 33747-1027
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | AS4766
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License Number State | FL
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