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Organization
LISA A SCUDDER DO PA
Active
Organization
LISA A SCUDDER DO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA ANN SCUDDER DO (PRESIDENT PHYSICIAN)
(813) 931-3999
Entity
Organization
Contact information
Practice address
2901 W BUSCH BLVD STE 403, SUITE 403, TAMPA, FL 33618-4566
(813) 931-3999
(813) 931-3999
Mailing address
2901 W BUSCH BLVD, SUITE 403, TAMPA, FL 33618-4523
(813) 931-3999
(813) 936-7147
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS7188
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
379545400
—
FL
Enumeration date
10/19/2005
Last updated
10/08/2014
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