Individual
DR. MULUGETA Z FISSHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
910 WILLISTON PARK PT STE 1000, LAKE MARY, FL 32746-2163
(407) 833-8028
Mailing address
910 WILLISTON PARK PT STE 1000, LAKE MARY, FL 32746-2163
(620) 794-1962
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
04-34999
KS
207RC0000X
Cardiovascular Disease Physician
04-34999
KS
207RI0011X
Interventional Cardiology Physician
04-34999
KS
207RI0011X
Interventional Cardiology Physician
Primary
ME131385
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200862580A
—
KS
Enumeration date
02/13/2007
Last updated
10/22/2020
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