Thomas A Fisk Md

LBN: Thomas A Fisk Md
Thomas A Fisk Md is an health care organization with primary practice located at New Interlochen Pediatrics 846 Lake Howell Rd, Maitland FL 32751. The organization recently has only one registered license in Suppliers / Non-Pharmacy Dispensing Site, which is considered as the primary health care specialty. Thomas A Fisk Md can be contacted via phone (407) 767-2477, or through Shackelford, Direndia via phone (800) 654-0889.

Contact Information

Primary practice address
New Interlochen Pediatrics 846 Lake Howell Rd Maitland FL 32751
Phone: (407) 767-2477
Fax: (407) 834-9822
Website:
Map and Directions
Authorized official contact:
Name: Shackelford, Direndia
Phone: (800) 654-0889

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Non-Pharmacy Dispensing Site 332900000X ME61050 Florida

Profile Details

NPI number 1376589481
LBN Legal business name Thomas A Fisk Md
DBA Doing business as
Authorized official Shackelford, Direndia
Entity Organization
Organization subpart 1 No
Enumeration date Jun 20th, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376589481 NPPES
Florida MEDICAID 58690100
Florida Other 1084312

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