Provider Demographics
NPI:1770859092
Name:FISHER, GEORGE H II (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:H
Last Name:FISHER
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:540 MEDICAL OAKS AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5995
Mailing Address - Country:US
Mailing Address - Phone:813-684-2211
Mailing Address - Fax:813-655-7669
Practice Address - Street 1:540 MEDICAL OAKS AVE STE 103
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5995
Practice Address - Country:US
Practice Address - Phone:813-684-2211
Practice Address - Fax:813-685-0895
Is Sole Proprietor?:No
Enumeration Date:2012-03-30
Last Update Date:2022-04-26
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Provider Licenses
StateLicense IDTaxonomies
FLME120552207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017384700Medicaid
FLP01728853OtherRAILROAD MEDICARE PTAN
FLP01728853OtherRAILROAD MEDICARE PTAN