MEDICARE: DR. LISA A WHIMS-SQUIRES D.O

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	207RP1001X	Pulmonary Disease Physician	0S6918	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9709589	OTHER	DC	GHI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	3617741	OTHER	FL	CIGNA
4	1745733	OTHER	FL	FIRST HEALTH

General Provider Information

NPI Number	:	1831133446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA A WHIMS-SQUIRES D.O

Provider Business Mailing Address
First Line	:	2840 W BAY DR
Second Line	:	SUITE 273
City	:	BELLEAIR BLUFFS
State	:	FL
Zip	:	33770-2620
Country	:	US
Telephone Number	:	727-466-9847
Fax Number	:	727-466-0346

Provider Business Practice Location Address
First Line	:	1305 SOUTH FT. HARRISON AVE.
Second Line	:	BLDG. G
City	:	CLEARWATER
State	:	FL
Zip	:	33756
Country	:	US
Telephone Number	:	727-466-9847
Fax Number	:	727-466-0346

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

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	01/06/2010

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Directions to “ DR. LISA A WHIMS-SQUIRES D.O” Practice Location

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