| Doctor Name: | DR. LISA LEE CUMMINGS |
| NPI Number: | 1114183894 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.P.M. |
| License Number: | PO 3248 |
| Business Practice Address: | 218a E Eau Gallie Blvd #163 Indian Harbour Beach, FL - 329374875 |
| Business Phone Number: | 3216155220 |
| Business Fax Number: | 3217774340 |
| Mailing Address: | 218a E Eau Gallie Blvd # 163, 163 INDIAN HARBOUR BEACH |
| State: | FL |
| Postal Code: | 329374875 |
| Phone Number: | 3216155220 |
| Fax Number: | 3217774340 |
| NPI Enumeration Date: | 08/01/2008 |
| NPI Last Update Date: | 12/28/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213EP1101X |
| License Number: | PO 3248 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Primary Podiatric Medicine |
| Taxonomy Definition: | |