Healthcare Provider Details
I. General information
NPI: 1447315171
Provider Name (Legal Business Name): LISA ANNE FRANCESCHINI WILDCATT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/22/2006
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
901 E BLOOMINGDALE AVE # 501
BRANDON FL
33511-8118
US
IV. Provider business mailing address
2995 DREW ST
CLEARWATER FL
33759-3012
US
V. Phone/Fax
- Phone: 813-699-3995
- Fax: 813-315-1625
- Phone: 727-315-7496
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 200301080 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | ME100761 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: