Gwynn, Lisa

Gwynn, Lisa is an individual health care provider with primary practice located at 4651 Sheridan St. Suite #270, Hollywood FL 33021-3422. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Gwynn, Lisa can be contacted via phone (954) 989-6000.

Contact Information

Primary practice address
4651 Sheridan St. Suite #270 Hollywood FL 33021-3422
Phone: (954) 989-6000
Fax: (954) 378-4775
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 0S8394 Florida

Profile Details

NPI number 1407848682
LBN Legal business name Gwynn, Lisa
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2005
Last updated Nov 10th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407848682 NPPES
Florida MEDICAID 262070700

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