Individual
MRS. LISA UPSHAW FUENTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13101 BRUCE B DOWNS BLVD, TAMPA, FL 33612-3803
(813) 974-0602
(813) 558-1343
Mailing address
13101 BRUCE B DOWNS BLVD, TAMPA, FL 33612-3803
(813) 974-0602
(813) 558-1343
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
12/17/2010
Last updated
01/13/2012
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