Individual
DR. MICHAEL FISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
10200 W STATE ROAD 84 STE 105, DAVIE, FL 33324-4218
(954) 370-7692
(954) 370-2383
Mailing address
4581 WESTON RD STE 374, WESTON, FL 33331-3141
(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
FL
01
—
73683
BLUE CROSS/BLUE SHIELD
FL
Enumeration date
10/10/2006
Last updated
03/17/2018
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