Individual
LARRY FISHMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
427 S PARSONS AVE, SUITE 110, BRANDON, FL 33511-5291
(813) 653-2770
(813) 654-6668
Mailing address
427 S PARSONS AVE, SUITE 110, BRANDON, FL 33511-5291
(813) 653-2770
(813) 654-6668
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
ME0053007
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
048364800
—
FL
Enumeration date
03/29/2006
Last updated
02/23/2012
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