MEDICARE: DR. DAVID ABRAHAM FISHBAIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	ME26494	FL

General Provider Information

NPI Number	:	1114954229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID ABRAHAM FISHBAIN MD

Provider Business Mailing Address
First Line	:	3798 MATHESON AVE
Second Line	:
City	:	COCONUT GROVE
State	:	FL
Zip	:	33133-6736
Country	:	US
Telephone Number	:	305-243-4060
Fax Number	:	305-665-4912

Provider Business Practice Location Address
First Line	:	1400 NW 10TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33136-1000
Country	:	US
Telephone Number	:	305-243-4060
Fax Number	:	305-665-4912

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	07/08/2007

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