Individual
LISA ANN UTSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
900 INGRAHAM AVE, HAINES CITY, FL 33844-4336
(863) 421-6565
(863) 421-7474
Mailing address
900 INGRAHAM AVE, HAINES CITY, FL 33844-4336
(863) 421-6565
(863) 421-7474
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME72026
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
172406
WELLCARE/STAYWELL
FL
05
—
256001101
—
FL
01
—
49399
BLUE CROSS BLUE SHIELD
FL
01
—
5831637
AETNA
FL
Enumeration date
10/23/2006
Last updated
01/12/2015
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