Basic Information
| Provider Information | |||||||||
| NPI: | 1467544726 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SIMPSON | ||||||||
| FirstName: | LISA | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MB, BCH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 801 6TH ST S | ||||||||
| Address2: | ACH BOX 1800 | ||||||||
| City: | ST PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337014816 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7277678166 | ||||||||
| FaxNumber: | 7277678160 | ||||||||
| Practice Location | |||||||||
| Address1: | 17 DAVIS BLVD | ||||||||
| Address2: | PEDIATRIC CLINIC, SUITE 100 | ||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336063475 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8132598867 | ||||||||
| FaxNumber: | 8132598792 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/28/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 1512 | FL | Y | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 5380 | HI | N | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.