Individual
DR. ALAN P FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2025 E EDGEWOOD DR, LAKELAND, FL 33803-3601
(863) 665-4515
(863) 665-4516
Mailing address
2025 E EDGEWOOD DR, LAKELAND, FL 33803-3601
(863) 665-4515
(863) 665-4516
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC1217
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084841700
—
FL
01
—
19436
BCBS
FL
01
—
4269694
AETNA
—
01
—
540002113
RAILROAD MEDICARE
—
01
—
591268685
TAX ID
FL
01
—
OP1217 899
WORKERS COMP
FL
01
—
U10328
DMERC
—
Enumeration date
10/10/2006
Last updated
05/26/2011
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