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Individual

MAYER FISHMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
12902 USF MAGNOLIA DR, GU PROGRAM, TAMPA, FL 33612-9416
(813) 745-8343
(813) 745-8494
Mailing address
12902 USF MAGNOLIA DR, GU PROGRAM, TAMPA, FL 33612-9416
(813) 745-8343
(813) 745-8494

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME74715
FL
207RX0202X
Medical Oncology Physician
Primary
ME74715
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
258831500
FL
01
35334
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/13/2006
Last updated
10/03/2014
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