Individual
LISA ZACK
Active
Individual
LISA ZACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
ME56408
FL
207ND0101X
MOHS-Micrographic Surgery Physician
ME56408
FL
207ND0900X
Dermatopathology Physician
Primary
ME56408
FL
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
ME56408
FL
207NP0225X
Pediatric Dermatology Physician
ME56408
FL
207NS0135X
Procedural Dermatology Physician
ME56408
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0387142
UNITED HEALTHCARE
FL
01
—
08856
BCBS
FL
01
—
568740
BCBS PA
FL
01
—
713505
TUFTS
FL
01
—
ZE2985
BCBS MA
FL
Enumeration date
06/21/2005
Last updated
09/29/2020
Update your record
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