Individual
LISA WYNNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3100 SW 62ND AVE, MIAMI, FL 33155-3009
(786) 624-2636
(305) 668-5595
Mailing address
3100 SW 62ND AVE, MIAMI, FL 33155-3009
(786) 624-2636
(305) 668-5595
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP1750482
FL
Other
Enumeration date
02/13/2007
Last updated
05/21/2014
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