Provider Demographics
NPI:1437759891
Name:ENGLISH, LISA TURNER
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:TURNER
Last Name:ENGLISH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4173 FELDWOOD CT
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-4005
Mailing Address - Country:US
Mailing Address - Phone:904-260-4407
Mailing Address - Fax:904-880-8945
Practice Address - Street 1:10991 SAN JOSE BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-6675
Practice Address - Country:US
Practice Address - Phone:904-260-4407
Practice Address - Fax:904-880-8945
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS23339183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist