Provider Demographics
NPI:1568606788
Name:CALLER, LISA (AP OR LAC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:CALLER
Suffix:
Gender:F
Credentials:AP OR LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6981 CURTISS AVE
Mailing Address - Street 2:SUITE #3
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-8100
Mailing Address - Country:US
Mailing Address - Phone:941-927-2400
Mailing Address - Fax:
Practice Address - Street 1:6981 CURTISS AVE
Practice Address - Street 2:SUITE #3
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-8100
Practice Address - Country:US
Practice Address - Phone:941-927-2400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-01
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL940171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist