Individual
MRS. LISA GWYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO.
Contact information
Practice address
1601 NW 12TH AVE STE 8008, MIAMI, FL 33136-1005
(305) 243-3440
Mailing address
4651 SHERIDAN ST., SUITE #270, HOLLYWOOD, FL 33021-3422
(954) 989-6000
(954) 378-4775
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0S8394
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
262070700
—
FL
Enumeration date
08/16/2005
Last updated
04/30/2026
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