Healthcare Provider Details

I. General information

NPI: 1689636920
Provider Name (Legal Business Name): LISA NEWCOMB ALAISH D.P.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 10/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4503 CURRY FORD RD
ORLANDO FL
32812-2710
US

IV. Provider business mailing address

40 OAK BEND CT
OVIEDO FL
32765-9232
US

V. Phone/Fax

Practice location:
  • Phone: 407-281-1414
  • Fax: 407-381-3370
Mailing address:
  • Phone: 407-971-4300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO2927
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: