| Doctor Name: | DR. LISA ANN REMALEY-WALTERS |
| NPI Number: | 1578501136 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | MD062655L |
| Business Practice Address: | 93 Wild Elm Ave Ponte Vedra, FL - 320818515 |
| Business Phone Number: | 8145283212 |
| Business Fax Number: | |
| Mailing Address: | 93 Wild Elm Ave, PONTE VEDRA |
| State: | FL |
| Postal Code: | 320818515 |
| Phone Number: | 8145283212 |
| Fax Number: | |
| NPI Enumeration Date: | 06/03/2006 |
| NPI Last Update Date: | 03/25/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | MD062655L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |