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General NPI Number Information
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NPI Number | 1831225036
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Entity Type | Individual
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Provider Name | PATRICK W FISHER D.O.
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Gender | Male
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Dates
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Enumeration Date | 02/24/2007
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Last Update Date | 06/26/2020
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Provider Practice Location Address
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Address Line | 1330 BUDINGER AVE STE 101
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City | SAINT CLOUD
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State | FL
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Zip | 34769-4137
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Country | US
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Telephone | 407-891-2940
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Fax | 407-891-2941
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Provider Business Mailing Address
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Address Line | 1330 BUDINGER AVE STE 108
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City | SAINT CLOUD
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State | FL
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Zip | 34769-4137
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Country | US
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Telephone | 407-891-2940
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Fax | 407-891-2941
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | OS11595
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 5177
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License Number State | OK
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