Individual
MR. KENNETH CLYDE FISCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1190 NW 95TH ST, STE 402, MIAMI, FL 33150
(305) 696-7666
(305) 694-0111
Mailing address
1190 NW 95TH ST, STE 402, MIAMI, FL 33150
(305) 696-7666
(305) 694-0111
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME0024675
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
035837100
—
FL
Enumeration date
05/12/2006
Last updated
06/30/2010
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