Individual
JODI ALLENE FIEDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
21020 STATE ROAD 7, SUITE 120, BOCA RATON, FL 33428-1320
(561) 883-5640
(561) 409-4010
Mailing address
21020 STATE ROAD 7, SUITE 120, BOCA RATON, FL 33428-1320
(561) 883-5640
(561) 409-4010
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME80070
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2200779
GHI PROVIDER ID
FL
01
—
2548084
AETNA PROVIDER ID
FL
05
—
261302600
—
FL
Enumeration date
07/26/2005
Last updated
04/02/2014
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