Provider Demographics
NPI:1740961010
Name:BONDS, LISA
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:BONDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7450 DR PHILLIPS BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-5120
Mailing Address - Country:US
Mailing Address - Phone:800-349-6119
Mailing Address - Fax:800-349-6119
Practice Address - Street 1:7450 DR PHILLIPS BLVD STE 205
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-5120
Practice Address - Country:US
Practice Address - Phone:800-349-6119
Practice Address - Fax:800-349-6119
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies