Individual
DR. MARK ROWELL FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
5455 MURRELL RD, SUITE 107, ROCKLEDGE, FL 32955-6615
(321) 636-1972
(321) 636-1507
Mailing address
5455 MURRELL ROAD, SUITE 107, VIERA, FL 32955-6615
(321) 636-1972
(321) 636-1507
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC 1739
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078956900
—
FL
01
—
19829
BCBS OF FL
FL
Enumeration date
06/13/2006
Last updated
03/31/2009
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