Individual
MRS. PATTY J LODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
755 RINEHART RD, SUITE 100, LAKE MARY, FL 32746-4874
(407) 333-1550
(407) 333-3081
Mailing address
755 RINEHART RD, SUITE 100, LAKE MARY, FL 32746-4874
(407) 333-1550
(407) 333-3081
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA1939
FL
Other
Enumeration date
06/07/2006
Last updated
06/13/2014
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