Individual
DUSTIN LUCAS LILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4500 W NEWBERRY RD, GAINESVILLE, FL 32607-2245
(352) 336-6000
(352) 332-0799
Mailing address
4500 W NEWBERRY RD, GAINESVILLE, FL 32607-2245
(352) 336-6000
(352) 332-0799
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9106670
FL
Other
Enumeration date
07/17/2012
Last updated
02/19/2015
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