Provider Demographics
NPI:1316931116
Name:FLEISHER, WILLIAM S (OD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:S
Last Name:FLEISHER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 NE 48TH ST
Mailing Address - Street 2:#307
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4960
Mailing Address - Country:US
Mailing Address - Phone:954-938-0273
Mailing Address - Fax:
Practice Address - Street 1:3100 NE 48TH ST
Practice Address - Street 2:#307
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4960
Practice Address - Country:US
Practice Address - Phone:954-938-0273
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL818152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
19218Medicare ID - Type Unspecified
I11870Medicare UPIN