Individual
LISA MARIE VACCARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
7171 N DALE MABRY HWY, TAMPA, FL 33614-2665
(904) 639-2000
(904) 639-2015
Mailing address
7171 N DALE MABRY HWY, TAMPA, FL 33614-2665
(813) 932-2222
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
18651
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/19/2019
Last updated
06/21/2022
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