Provider Demographics
NPI:1437152667
Name:FISCHER, FRANK J JR (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:J
Last Name:FISCHER
Suffix:JR
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 1:215 1ST ST N
Mailing Address - Street 2:STE 200
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-4537
Mailing Address - Country:US
Mailing Address - Phone:863-294-5457
Mailing Address - Fax:863-293-0343
Practice Address - Street 1:215 1ST ST N
Practice Address - Street 2:STE 200
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-4537
Practice Address - Country:US
Practice Address - Phone:863-294-5457
Practice Address - Fax:863-293-0343
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2015-01-06
Deactivation Date:2006-03-15
Deactivation Code:
Reactivation Date:2006-03-29
Provider Licenses
StateLicense IDTaxonomies
FLME9736207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL45287400Medicaid
FL53334YMedicare PIN
FLD56459Medicare UPIN