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General NPI Number Information
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NPI Number | 1477592426
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Entity Type | Organization
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Legal Business Name | LISA WHIMS-SQUIRES, D.O., PA
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 01/06/2010
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Provider Practice Location Address
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Address Line | 1305 S FORT HARRISON AVE BLDG. G
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City | CLEARWATER
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State | FL
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Zip | 33756-3301
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Country | US
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Telephone | 727-466-9847
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Fax | 727-466-0346
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Provider Business Mailing Address
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Address Line | 2840 W BAY DR SUITE 273
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City | BELLEAIR BLUFFS
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State | FL
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Zip | 33770-2620
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Country | US
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Telephone | 727-466-9847
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Fax | 727-466-0346
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Authorized Official
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Title or Position | P.A.
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Name | DR. LISA A WHIMS-SQUIRES
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Credential | D.O.
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Telephone | 727-466-9847
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | OS6918
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License Number State | FL
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