Organization
MICHAEL FISH PHD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL FISH PH.D. (PRESIDENT/PSYCHOLOGIST)
(954) 370-7692
Entity
Organization
Contact information
Practice address
10200 W STATE ROAD 84 STE 105, DAVIE, FL 33324-4218
(954) 370-7692
(954) 370-2383
Mailing address
1304 SW 160TH AVE, SUITE 339, SUNRISE, FL 33326-1902
(954) 370-7692
(954) 370-2383
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY3726
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056610
VALUE OPTIONS/TRICARE
FL
01
—
73683
BLUE CROSS/BLUE SHIELD
FL
Enumeration date
11/06/2007
Last updated
10/09/2017
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