Provider Demographics
NPI:1467544726
Name:SIMPSON, LISA ANN (MB, BCH)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:ANN
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:MB, BCH
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:801 6TH ST S
Mailing Address - Street 2:ACH BOX 1800
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4816
Mailing Address - Country:US
Mailing Address - Phone:727-767-8166
Mailing Address - Fax:727-767-8160
Practice Address - Street 1:17 DAVIS BLVD
Practice Address - Street 2:PEDIATRIC CLINIC, SUITE 100
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3475
Practice Address - Country:US
Practice Address - Phone:813-259-8867
Practice Address - Fax:813-259-8792
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL1512208000000X
HI5380208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics