Provider Demographics
NPI:1689966657
Name:YEHUDA FISHFELD, MD,PA
Entity Type:Organization
Organization Name:YEHUDA FISHFELD, MD,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YEHUDA
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHFELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-429-9047
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:33441-1604
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:33441-1604
Practice Address - Country:US
Practice Address - Phone:954-429-9047
Practice Address - Fax:954-429-1007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0048148207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL407005OtherAETNA
FL100510OtherAVMED
FLD20727Medicare UPIN