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Individual
LISETH GRAHAM
Active
Individual
LISETH GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
25-499
FL
363A00000X
Physician Assistant
Primary
3180-P.A.
PR
363AS0400X
Surgical Physician Assistant
3180-P.A.
PR
Other
Enumeration date
06/01/2026
Last updated
06/01/2026
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