Provider Demographics
NPI:1366501439
Name:FISHFELD, YEHUDA (MD)
Entity Type:Individual
Prefix:DR
First Name:YEHUDA
Middle Name:
Last Name:FISHFELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 W HILLSBORO BLVD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441
Mailing Address - Country:US
Mailing Address - Phone:954-429-9047
Mailing Address - Fax:954-429-1007
Practice Address - Street 1:450 W HILLSBORO BLVD
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441
Practice Address - Country:US
Practice Address - Phone:954-429-9047
Practice Address - Fax:954-429-1007
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0048148207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100510OtherAVMED
FL407005OtherAETNA
DCD20727Medicare UPIN
FL02243Medicare ID - Type Unspecified