Provider Demographics
NPI:1013078815
Name:FISCHER, DARLENE (PA)
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:
Last Name:FISCHER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 WHITE ST
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-4871
Mailing Address - Country:US
Mailing Address - Phone:305-923-6652
Mailing Address - Fax:
Practice Address - Street 1:2506 N ROOSEVELT BLVD STE 103
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-3951
Practice Address - Country:US
Practice Address - Phone:305-973-5582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1184363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant