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General NPI Number Information
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NPI Number | 1700960507
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Entity Type | Organization
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Legal Business Name | FISHMAN & SHERIDAN MD PA
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 08/26/2024
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Provider Practice Location Address
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Address Line | 640 S LAKE ST
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City | LEESBURG
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State | FL
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Zip | 34748-5927
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Country | US
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Telephone | 352-360-2301
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Fax | 352-315-7631
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Provider Business Mailing Address
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Address Line | 640 S LAKE ST STE 102
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City | LEESBURG
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State | FL
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Zip | 34748-5921
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Country | US
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Telephone | 352-360-2301
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Fax | 352-315-7631
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. JEFFREY A SHERIDAN
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Credential | M.D.
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Telephone | 352-360-2301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State | FL
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