| Doctor Name: | LISA MARIE LAUDERDALE |
| NPI Number: | 1043551328 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | ARNP1726292 |
| Business Practice Address: | 1840 Mease Dr Suite 402 Safety Harbor, FL - 346956602 |
| Business Phone Number: | 7273307652 |
| Business Fax Number: | |
| Mailing Address: | 2109 Gull Ln, SAFETY HARBOR |
| State: | FL |
| Postal Code: | 346954919 |
| Phone Number: | 7277263223 |
| Fax Number: | |
| NPI Enumeration Date: | 03/11/2013 |
| NPI Last Update Date: | 03/11/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | ARNP1726292 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |