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Individual

LISA ZACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
801 ANCHOR RODE DR, STE 100, NAPLES, FL 34103-2742
(239) 263-1717
(239) 403-9410
Mailing address
801 ANCHOR RODE DR, STE 100, NAPLES, FL 34103-2742
(239) 263-1717
(239) 403-9410

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
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