Provider Demographics
NPI:1013420397
Name:FIFER & HELIGMAN MD PA
Entity Type:Organization
Organization Name:FIFER & HELIGMAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHARLYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:MERCER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-482-3110
Mailing Address - Street 1:8350 RIVERWALK PARK BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-8759
Mailing Address - Country:US
Mailing Address - Phone:239-482-3110
Mailing Address - Fax:239-425-6913
Practice Address - Street 1:10201 ARCOS AVE STE 206
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-9461
Practice Address - Country:US
Practice Address - Phone:239-992-3117
Practice Address - Fax:239-992-7248
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FIFER & HELIGMAN MD PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-09
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site