Provider Demographics
NPI:1578866745
Name:PAUL E FISHER JR OD PA
Entity Type:Organization
Organization Name:PAUL E FISHER JR OD PA
Other - Org Name:DR FISHER AND ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:727-498-8808
Mailing Address - Street 1:5838 9TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST. PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-6319
Mailing Address - Country:US
Mailing Address - Phone:727-498-8808
Mailing Address - Fax:727-498-8807
Practice Address - Street 1:5838 9TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-6319
Practice Address - Country:US
Practice Address - Phone:727-498-8808
Practice Address - Fax:727-498-8807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-10
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3466152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty