Individual
DR. MATTHEW JOSEPH LISANKIE II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2600 BRUCE B DOWNS BLVD, WESLEY CHAPEL, FL 33544-9207
(813) 929-5000
Mailing address
12802 TAMPA OAKS BLVD STE 300, TEMPLE TERRACE, FL 33637-1903
(813) 615-0124
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME132249
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/14/2014
Last updated
07/21/2022
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