Organization
HOMESTEADMED PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES FISH DO (PRESIDENT)
(866) 396-6418
Entity
Organization
Contact information
Practice address
160 NW 13TH ST, HOMESTEAD, FL 33030-4228
(786) 243-8000
Mailing address
PO BOX 863997, ORLANDO, FL 32886-3997
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24126
BCBS
FL
01
—
DF5448
RAILROAD
FL
Enumeration date
04/10/2006
Last updated
08/22/2020
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