Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | PO2777 | FL |
NPI | 1255439352 |
---|---|
Provider Name | Lisa Norman Klemeyer |
First Address | Sarasota, FL 34233-2447 |
Second Address | Sarasota, FL 34233-3332 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 13/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U75794 | (02) |