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Individual

DR. MICHELLE L LISTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
21097 NE 27TH CT, SUITE 100, AVENTURA, FL 33180-1204
(305) 792-0012
(305) 792-0030
Mailing address
3801 BISCAYNE BLVD, 3RD FLOOR, MIAMI, FL 33137-9800
(305) 571-0620
(305) 576-8099

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME69939
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
260903700
FL
Enumeration date
07/20/2005
Last updated
02/09/2022
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