Provider Demographics
NPI:1558707752
Name:FLETCHER, EMILY J (MD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:J
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:J
Other - Last Name:SWEET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5992 BERRYHILL RD STE 203
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32570-1014
Mailing Address - Country:US
Mailing Address - Phone:850-626-5391
Mailing Address - Fax:850-626-5388
Practice Address - Street 1:5992 BERRYHILL RD STE 203
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570-1014
Practice Address - Country:US
Practice Address - Phone:850-626-5391
Practice Address - Fax:850-626-5388
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01074875A208600000X
390200000X
FLME154647208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program