Provider Demographics
NPI:1689636920
Name:ALAISH, LISA NEWCOMB (DPM)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:NEWCOMB
Last Name:ALAISH
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 OAK BEND CT
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-9232
Mailing Address - Country:US
Mailing Address - Phone:407-971-4300
Mailing Address - Fax:
Practice Address - Street 1:4503 CURRY FORD RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32812-2710
Practice Address - Country:US
Practice Address - Phone:407-281-1414
Practice Address - Fax:407-381-3370
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2927213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL340199500Medicaid
FLU86084Medicare UPIN
FL65706Medicare PIN
FL340199500Medicaid
FL24366Medicare PIN