Provider Demographics
NPI:1154766632
Name:FISHER, RYAN MATTHEW (MD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:MATTHEW
Last Name:FISHER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2789 S STATE ROAD 7 STE 100
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-9360
Mailing Address - Country:US
Mailing Address - Phone:561-898-5100
Mailing Address - Fax:561-898-5103
Practice Address - Street 1:2789 S STATE ROAD 7 STE 100
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-9360
Practice Address - Country:US
Practice Address - Phone:561-898-5100
Practice Address - Fax:561-898-5103
Is Sole Proprietor?:No
Enumeration Date:2013-05-09
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXQ6189207Q00000X
FLME153626207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine