Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | MA44817 | FL |
NPI | 1720058035 |
---|---|
Provider Name | Ms. Lisa M. Fruscella |
First Address | Sunrise, FL 33351-8208 |
Second Address | Sunrise, FL 33351-8208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2006 |
Last Update Date | 08/07/2007 |