# LISA S GAMELL

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1629051651
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | ME 99976 | FL | Yes |
| 207WX0009X | Glaucoma Specialist (Ophthalmology) Physician | ME99976 | FL | — |

## Other

- **Enumeration date:** 11/23/2005
- **Last updated:** 10/15/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 11299 | BLUE CROSS BLUE SHIELD | FL |
| 05 | — | 280206600 | — | FL |