Healthcare Provider Details

I. General information

NPI: 1497733844
Provider Name (Legal Business Name): LISA D'AUGELLI M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2424 NW 35TH ST
BOCA RATON FL
33431-5412
US

IV. Provider business mailing address

2424 NW 35TH ST
BOCA RATON FL
33431-5412
US

V. Phone/Fax

Practice location:
  • Phone: 561-479-0231
  • Fax: 561-479-0231
Mailing address:
  • Phone: 561-479-0231
  • Fax: 561-479-0231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: