Individual
DR. LISA JEANNE SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1315 E 7TH AVE STE 104, TAMPA, FL 33605-3606
(813) 396-9021
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 974-2201
(813) 974-2812
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
53030
FL
2080P0208X
Pediatric Infectious Diseases Physician
Primary
ME53030
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107818200
—
FL
01
—
18532
BLUE CROSS BLUE SHIELD
FL
01
—
MY949
MEDICARE
FL
Enumeration date
11/13/2018
Last updated
10/27/2020
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