Individual
DR. ANNA RADISIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
160 ESSEX ST STE 102, LODI, NJ 07644-2709
(551) 996-8111
(551) 996-8445
Mailing address
17 DAVIS BLVD STE 308, TAMPA, FL 33606-3438
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA12521300
NJ
207R00000X
Internal Medicine Physician
ME160304
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118138600
—
FL
01
—
S4OQ7
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/28/2020
Last updated
07/11/2025
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