Organization
LISA M JUDGE M D P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN ROUTHIER (PRACTICE MANAGER)
(850) 729-1414
Entity
Organization
Contact information
Practice address
552 TWIN CITIES BLVD, SUITE C, NICEVILLE, FL 32578-1055
(850) 729-1414
(850) 729-8700
Mailing address
552 TWIN CITIES BLVD, SUITE C, NICEVILLE, FL 32578-1055
(850) 729-1414
(850) 729-8700
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN7294
RR MEDICARE GROUP PTAN
FL
Enumeration date
06/04/2007
Last updated
06/23/2009
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