Individual
DR. LISA CYNTHIA HAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12196 COUNTY ROAD 512, FELLSMERE, FL 32948-5463
(772) 257-8224
(772) 252-3245
Mailing address
1555 INDIAN RIVER BLVD STE B210, VERO BEACH, FL 32960-7113
(772) 257-8224
(772) 252-3245
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME116550
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME116550
STATE LICENSE
FL
Enumeration date
11/07/2012
Last updated
02/05/2025
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