Individual
DR. LISA MARIE RUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4911 S MANHATTAN AVE, TAMPA, FL 33611-3429
(813) 755-4025
(813) 755-4026
Mailing address
720 BROOKER CREEK BLVD STE 215, OLDSMAR, FL 34677-2937
(813) 854-2003
(813) 436-5378
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME130932
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021632800
—
FL
Enumeration date
04/16/2014
Last updated
10/12/2023
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