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NPI Code Detail

MEDICARE: LISA PAINTER

MEDICARE: LISA PAINTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistDN 20707FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083031926
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA PAINTER
Provider Business Mailing Address
First Line : PO BOX 82969
Second Line :
City : TAMPA
State : FL
Zip : 33682-2969
Country : US
Telephone Number : 813-866-0930
Fax Number : 813-866-0929
Provider Business Practice Location Address
First Line : 8108 N NEBRASKA AVE
Second Line :
City : TAMPA
State : FL
Zip : 33604-3103
Country : US
Telephone Number : 813-712-1930
Fax Number : 813-712-1929
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2014
Last Update Date : 07/26/2014

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Directions to “ LISA PAINTER ” Practice Location

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