Provider Demographics
NPI:1831133446
Name:WHIMS-SQUIRES, LISA A (DO)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:A
Last Name:WHIMS-SQUIRES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2840 W BAY DR
Mailing Address - Street 2:SUITE 273
Mailing Address - City:BELLEAIR BLUFFS
Mailing Address - State:FL
Mailing Address - Zip Code:33770-2620
Mailing Address - Country:US
Mailing Address - Phone:727-466-9847
Mailing Address - Fax:727-466-0346
Practice Address - Street 1:1305 SOUTH FT. HARRISON AVE.
Practice Address - Street 2:BLDG. G
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756
Practice Address - Country:US
Practice Address - Phone:727-466-9847
Practice Address - Fax:727-466-0346
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL0S6918207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC9709589OtherGHI
FL256024100Medicaid
FL3617741OtherCIGNA
FL1745733OtherFIRST HEALTH
FLG72869Medicare UPIN
FL256024100Medicaid