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NPI Code Detail

MEDICARE: LISA J WAIZENEGGER M.D.

MEDICARE: LISA J WAIZENEGGER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Y00000XOtolaryngology PhysicianME98558FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326042656
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA J WAIZENEGGER M.D.
Provider Business Mailing Address
First Line : 15280 NW 79TH CT STE 200
Second Line :
City : MIAMI LAKES
State : FL
Zip : 33016-5873
Country : US
Telephone Number : 305-558-3724
Fax Number : 786-907-4485
Provider Business Practice Location Address
First Line : 5830 LAKE UNDERHILL RD
Second Line :
City : ORLANDO
State : FL
Zip : 32807-4311
Country : US
Telephone Number : 407-658-0228
Fax Number : 407-282-5483
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 12/19/2022

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