Provider Demographics
NPI:1104902584
Name:FISHER, JEROME PETER (MD)
Entity type:Individual
Prefix:DR
First Name:JEROME
Middle Name:PETER
Last Name:FISHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7350 SW 108TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-3854
Mailing Address - Country:US
Mailing Address - Phone:305-665-2716
Mailing Address - Fax:305-669-4412
Practice Address - Street 1:7350 SW 108TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-3854
Practice Address - Country:US
Practice Address - Phone:305-665-2716
Practice Address - Fax:305-669-4412
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME30603207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology