Lisa Clayville Martin, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

42543 Issued in FL

Practice address

960 Back Stage LN
Lake Buena Vista, FL 32830-8472

Phone

(407) 934-2505

NPI assigned

Nov 19, 2007

Last updated

Apr 8, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396915200000",
    "number": "1497936462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 DURANGO LOOP ST",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338975685",
            "telephone_number": "410-251-2349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 BACK STAGE LN",
            "city": "LAKE BUENA VISTA",
            "state": "FL",
            "postal_code": "328308472",
            "telephone_number": "407-934-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "LISA",
        "middle_name": "CLAYVILLE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-19",
        "last_updated": "2014-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "42543",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "18358",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashton Tyquilan Cobb, PHARMD, RPH
• Thomas Robert Dyroff
• Michelle Lynnette Hall, M.D.
• Michael Wayne Hankins, M.D.
• Sharon Rae Krumins, M.D.
• Joseph Carney Metz III, MS, ATC, CSCS
• Jeffrey Thomas Nelson, D.O.
• Melvin Nguyen, PHARMD
• Boris Fabricio Onate, M.D
• Phuong K Ong, PHARM D

• Pharmacist in Lake Buena Vista, FL
• Providers in Lake Buena Vista, FL by specialty
• Pharmacist in Florida

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