Lisa a Scudder DO PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS7188 Issued in FL

Legal business name

LISA A SCUDDER DO PA

Practice address

2901 W Busch Blvd Ste 403
Suite 403
Tampa, FL 33618-4566

Phone

(813) 931-3999

Fax

(813) 931-3999

NPI assigned

Oct 19, 2005

Organization subpart

No

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

Authorized official

Name

Lisa Ann Scudder, DO

Title

President Physician

Phone

(813) 931-3999

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412726400000",
    "number": "1477542769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 W BUSCH BLVD",
            "address_2": "SUITE 403",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336184523",
            "telephone_number": "813-931-3999",
            "fax_number": "813-936-7147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 W BUSCH BLVD STE 403",
            "address_2": "SUITE 403",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336184566",
            "telephone_number": "813-931-3999",
            "fax_number": "813-931-3999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA A SCUDDER DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-19",
        "last_updated": "2014-10-08",
        "status": "A",
        "authorized_official_last_name": "SCUDDER",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT PHYSICIAN",
        "authorized_official_telephone_number": "813-931-3999",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS7188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "379545400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Claire M Lipton, LCSW
• Alan M Lipzin, L.M.H.C.
• Liquid Mind Wellness, LLC
• Sylwia Liro
• Erin Lis
• Lisa Bentivenga LCSW P LLC
• Lisa Indelicato SLP-Pros, Inc
• Lisa M. Petrica-Moser, PH.D. Inc.
• Lisset Maria Suarez MD PA
• Lissmart Medical Supplies Inc

• Family Medicine Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2014; 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.