Healthcare Provider Details

I. General information

NPI: 1891084018
Provider Name (Legal Business Name): LISA C HAYES D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA C OELSCHLAEGER

II. Dates (important events)

Enumeration Date: 03/29/2011
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 E BLOOMINGDALE AVE STE 501
BRANDON FL
33511-8118
US

IV. Provider business mailing address

900 S PINE ISLAND RD SUITE 800
PLANTATION FL
33324-3920
US

V. Phone/Fax

Practice location:
  • Phone: 813-699-3995
  • Fax:
Mailing address:
  • Phone: 813-689-7571
  • Fax: 813-654-8129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOS12662
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: