Polhamus, Lisa Marie

Polhamus, Lisa Marie is an sole proprietor health care provider with primary practice located at 501 6Th Ave S , St Petersburg FL 33701. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Neonatal, which is considered as her primary health care specialty. Polhamus, Lisa Marie can be contacted via phone (727) 767-4313.

Contact Information

Primary practice address
501 6Th Ave S St Petersburg FL 33701
Phone: (727) 767-4313
Fax: (727) 767-4391
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X ARNP9481675 Florida

Profile Details

NPI number 1114188604
LBN Legal business name Polhamus, Lisa Marie
Credentials NNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 18th, 2008
Last updated Jun 20th, 2018 - about 7 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 1114188604 NPPES
Florida MEDICAID 024415700

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