Individual
LAUREN LIEB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
425 S KINGS AVE, BRANDON, FL 33511-5919
(813) 661-6199
(813) 661-6334
Mailing address
425 S KINGS AVE, BRANDON, FL 33511-5919
(813) 661-6199
(813) 661-6334
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5601006094
MI
363AM0700X
Medical Physician Assistant
50003079
OH
363AM0700X
Medical Physician Assistant
Primary
—
FL
Other
Enumeration date
08/03/2010
Last updated
06/18/2020
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