Individual
LISANDRA VIDAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, ARNP, CPNP-PC
Contact information
Practice address
7960 SW 60TH AVE, OCALA, FL 34476-6408
(352) 671-6471
Mailing address
7960 SW 60TH AVE, OCALA, FL 34476-6408
(352) 671-6471
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP9354868
FL
Other
Enumeration date
10/19/2016
Last updated
10/19/2016
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