Provider Demographics
NPI:1720398878
Name:WELSH, LISA JEAN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:JEAN
Last Name:WELSH
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:9350 SUNSET DR
Mailing Address - Street 2:STE 200
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3286
Mailing Address - Country:US
Mailing Address - Phone:786-594-4210
Mailing Address - Fax:
Practice Address - Street 1:8900 N KENDALL DR
Practice Address - Street 2:MIAMI CANCER INSTITUTE
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2118
Practice Address - Country:US
Practice Address - Phone:786-596-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2017-03-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9105588363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHB551YMedicare PIN