Individual
LISA FAY HEARN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12720 E US HIGHWAY 92, DOVER, FL 33527-4138
(813) 297-1438
(813) 297-1438
Mailing address
12720 E US HIGHWAY 92, DOVER, FL 33527-4138
(813) 297-1438
(813) 297-1438
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
683435396
FL
Other
Enumeration date
04/23/2026
Last updated
04/23/2026
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