Lisa Edgerton DO PA

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

OS 8636 Issued in FL

Legal business name

LISA EDGERTON DO PA

Practice address

114 NE 107TH St
Miami Shores, FL 33161-7032

Phone

(786) 390-8684

Fax

(305) 654-5270

NPI assigned

Apr 11, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Lisa M Edgerton, D.O.NPI 1093816266

Title

President

Phone

(786) 390-8684

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa Marie Edgerton, D.O.

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Lansing, MI
  • NPI 1093816266

  Adult Medicine

  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207872000000",
    "number": "1366615254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 NE 107TH ST",
            "city": "MIAMI SHORES",
            "state": "FL",
            "postal_code": "331617032",
            "telephone_number": "786-390-8684",
            "fax_number": "305-654-5270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 NE 107TH ST",
            "city": "MIAMI SHORES",
            "state": "FL",
            "postal_code": "331617032",
            "telephone_number": "786-390-8684",
            "fax_number": "305-654-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA EDGERTON DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-11",
        "last_updated": "2008-04-11",
        "status": "A",
        "authorized_official_last_name": "EDGERTON",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-390-8684",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": "OS 8636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lifecore Inc
• Blidgie Lightfoot, APRN
• Linda F Bach MD PA
• Michael David Lineman
• Lisa Edgerton
• Little People, P a
• Little Stars Dentistry of Miami Shores
• Little Stars Dentistry of Miami Shores
• Sheila Llanes, MD
• Katie Luz Lopez

• Adult Medicine Physician in Miami Shores, FL
• Providers in Miami Shores, FL by specialty
• Adult Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.