MEDICARE: LISA ANN STEWART FNP

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
1	363LF0000X	Family Nurse Practitioner	ARNP9191272	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1396268488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA ANN STEWART FNP

Provider Business Mailing Address
First Line	:	400 GOLF BROOK CIR APT 108
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32779-6107
Country	:	US
Telephone Number	:	941-916-5603
Fax Number	:

Provider Business Practice Location Address
First Line	:	1098 MONTGOMERY RD
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32714-7420
Country	:	US
Telephone Number	:	866-389-2727
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2017
Last Update Date	:	07/20/2017

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