Individual
LAWRENCE ALBERT LISSKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4130 SALISBURY RD, SUITE 1900, JACKSONVILLE, FL 32216-8031
(904) 281-0234
(904) 281-0236
Mailing address
4130 SALISBURY RD, SUITE 1900, JACKSONVILLE, FL 32216-8031
(904) 281-0234
(904) 281-0236
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
0029258
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004628900
—
FL
Enumeration date
11/07/2006
Last updated
03/13/2014
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