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General NPI Number Information
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NPI Number | 1356531065
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Entity Type | Organization
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Legal Business Name | SOLSUN MEDICAL INC
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Dates
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Enumeration Date | 07/29/2007
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Last Update Date | 12/03/2008
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Provider Practice Location Address
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Address Line | 1451 NE 4TH AVE
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City | FORT LAUDERDALE
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State | FL
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Zip | 33304-1033
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Country | US
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Telephone | 954-627-9118
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Fax | 954-627-9822
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Provider Business Mailing Address
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Address Line | 1451 NE 4TH AVE
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City | FORT LAUDERDALE
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State | FL
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Zip | 33304-1033
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Country | US
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Telephone | 954-627-9118
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Fax | 954-627-9822
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Authorized Official
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Title or Position | OWNER
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Name | DR. DONALD D FISHER
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Credential | DO
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Telephone | 954-627-9118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS0003995
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License Number State | FL
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