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General NPI Number Information
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NPI Number | 1225395668
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Entity Type | Organization
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Legal Business Name | KENNETH C. FISCHER, M.D., P.A.
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Dates
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Enumeration Date | 04/23/2012
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Last Update Date | 04/23/2012
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Provider Practice Location Address
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Address Line | 1190 NW 95TH ST SUITE #402
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City | MIAMI
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State | FL
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Zip | 33150-2063
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Country | US
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Telephone | 305-696-7666
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Fax | 305-694-0111
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Provider Business Mailing Address
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Address Line | 1190 NW 95TH ST SUITE #402
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City | MIAMI
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State | FL
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Zip | 33150-2063
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Country | US
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Telephone | 305-696-7666
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Fax | 305-694-0111
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Authorized Official
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Title or Position | PRESIDENT
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Name | KENNETH CLYDE FISCHER
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Credential | MD
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Telephone | 305-696-7666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | ME24675
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License Number State | FL
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