Provider Demographics
NPI:1811181274
Name:JOYCE, LISA SUSAN (PA9104231)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:SUSAN
Last Name:JOYCE
Suffix:
Gender:F
Credentials:PA9104231
Other - Prefix:MISS
Other - First Name:LISA
Other - Middle Name:SUSAN
Other - Last Name:MALLOY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:3401 PGA BLVD STE 310
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-2824
Mailing Address - Country:US
Mailing Address - Phone:561-776-8890
Mailing Address - Fax:561-766-2159
Practice Address - Street 1:3401 PGA BLVD STE 310
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-2824
Practice Address - Country:US
Practice Address - Phone:561-776-8890
Practice Address - Fax:561-766-2159
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9104231363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical