Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | ME40766 | FL |
NPI | 1164539011 |
---|---|
Provider Name | Lise M Lambert |
First Address | Ft Lauderdale, FL 33308-6420 |
Second Address | Ft Lauderdale, FL 33308-6420 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
379292700 | (05) | FL |
F41386 | (02) | FL |