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Organization
LISA RANKIN MD PA
Active
Organization
LISA RANKIN MD PA
Active
Other names
Coastal Integrative Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA M RANKIN M.D., P.A. (OWNER/AGENT)
(772) 344-1409
Entity
Organization
Contact information
Practice address
499 NW PRIMA VISTA BLVD, SUITE 105, PORT ST LUCIE, FL 34983-8786
(772) 344-1409
(772) 344-9441
Mailing address
499 NW PRIMA VISTA BLVD, SUITE 105, PORT ST LUCIE, FL 34983-8786
(772) 344-1409
(772) 344-9441
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME0074325
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
253926800
—
FL
Enumeration date
04/14/2008
Last updated
01/24/2012
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