Individual
DR. LISA M SORRELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
206 2ND ST E, BRADENTON, FL 34208-1042
(941) 955-4101
(941) 358-9817
Mailing address
8374 MARKET ST, BOX 502, LAKEWOOD RANCH, FL 34202-5137
(941) 955-4101
(941) 358-9817
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
5860777-1205
UT
2085R0202X
Diagnostic Radiology Physician
Primary
ME96808
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276420200
—
FL
05
—
D6158
—
UT
Enumeration date
06/07/2006
Last updated
05/26/2010
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