Individual
MRS. LISA WAGGONER BARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2061 COLLIER PKWY, LAND O LAKES, FL 34639-5202
(727) 845-5707
(813) 501-8250
Mailing address
2061 COLLIER PKWY, LAND O LAKES, FL 34639-5202
(727) 845-5707
(813) 501-8250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
30616
KY
2086H0002X
Hospice and Palliative Medicine (Surgery) Physician
Primary
ME128980
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000045747
BLUE CROSS AND BLUE SHIELD
—
01
—
000000583695
BLUE CROSS AND BLUE SHIELD
—
05
—
64306160
—
KY
Enumeration date
01/27/2006
Last updated
03/17/2018
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