Basic Information
| Provider Information | |||||||||
| NPI: | 1407828148 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FISHMAN | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5431 N UNIVERSITY DR | ||||||||
| Address2: | |||||||||
| City: | CORAL SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330674639 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543442522 | ||||||||
| FaxNumber: | 9543449189 | ||||||||
| Practice Location | |||||||||
| Address1: | 951 NW 13TH ST | ||||||||
| Address2: | SUITE 2E | ||||||||
| City: | BOCA RATON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334862337 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5613683455 | ||||||||
| FaxNumber: | 5613688642 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2006 | ||||||||
| LastUpdateDate: | 10/10/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | ME31775 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.