Individual
MRS. MONIQUE L LISOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., L.D.
Contact information
Practice address
4231 SOUTH PIPKIN ROAD, LAKELAND, FL 33811
(863) 323-4194
Mailing address
13000 BRUCE B DOWNS BLVD, ATTN: LAKELAND CBOC CLINIC, TAMPA, FL 33612-4745
(813) 972-2000
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND 4795
FL
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
ND4795
FL
Other
Enumeration date
11/11/2008
Last updated
12/05/2019
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