Individual
DR. MARK STEVEN FISHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3000 SW 148TH AVE STE 115, MIRAMAR, FL 33027-4181
(954) 438-7000
(954) 589-1742
Mailing address
3000 SW 148TH AVE STE 115, MIRAMAR, FL 33027-4181
(954) 438-7000
(954) 589-1742
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
OS9439
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002422800
—
FL
01
—
002876700
GROUP MEDICAID
FL
01
—
K0493
GROUP MEDICARE PTAN
—
01
—
P00418194
MEDICARE RAILROAD RETIREMENT
—
Enumeration date
04/04/2006
Last updated
12/05/2019
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