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Organization
LISA EDGERTON DO PA
Active
Organization
LISA EDGERTON DO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA M EDGERTON D.O. (PRESIDENT)
(786) 390-8684
Entity
Organization
Contact information
Practice address
114 NE 107TH ST, MIAMI SHORES, FL 33161-7032
(786) 390-8684
(305) 654-5270
Mailing address
114 NE 107TH ST, MIAMI SHORES, FL 33161-7032
(786) 390-8684
(305) 654-5270
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
OS 8636
FL
Other
Enumeration date
04/11/2008
Last updated
04/11/2008
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