Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | ME29604 | FL |
N | 208600000X | Surgeon | ME29604 | FL |
Y | 2086S0122X | Plastic and Reconstructive Surgery | ME29604 | FL |
NPI | 1275563801 |
---|---|
Provider Name | Joseph Howard Fishman |
First Address | Tampa, FL 33623-4447 |
Second Address | Clearwater, FL 33756-3335 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 28/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
79047 | BCBS (01) | FL |
D58630 | (02) |