Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | ME108870 | FL |
NPI | 1316080393 |
---|---|
Provider Name | Dr. Lisa C. Barkley |
First Address | Orlando, FL 32817-1492 |
Second Address | Orlando, FL 32817-1492 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 10/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000822901 | (05) | DE |
062386 | (02) | DE |