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Individual

MRS. LISA DEWITT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
12425 RACE TRACK RD, SUITE NUMBER 100, TAMPA, FL 33626-3102
(800) 659-1522
(800) 776-7713
Mailing address
12425 RACE TRACK RD, SUITE NUMBER 100, TAMPA, FL 33626-3102
(800) 659-1522
(800) 776-7713

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN189269 NP
GA

Other

Enumeration date
07/03/2010
Last updated
07/03/2010
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