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General NPI Number Information
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NPI Number | 1750265377
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Entity Type | Individual
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Provider Name | LISA TINIQUA FLOOD
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Gender | Female
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 1504 LEESBURG RD
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City | COLUMBIA
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State | SC
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Zip | 29209-2214
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Country | US
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Telephone | 803-262-1229
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Fax |
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Provider Business Mailing Address
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Address Line | 267 ALEXANDER POINTE DR
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City | HOPKINS
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State | SC
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Zip | 29061-8228
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Country | US
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Telephone | 803-386-4007
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number | 007202196
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License Number State | SC
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