Provider Demographics
NPI:1922539436
Name:DINH, LISA ANN (MD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:DINH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5950 S FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-2532
Mailing Address - Country:US
Mailing Address - Phone:863-688-3550
Mailing Address - Fax:863-687-8969
Practice Address - Street 1:5950 S FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2532
Practice Address - Country:US
Practice Address - Phone:636-883-5508
Practice Address - Fax:863-687-8969
Is Sole Proprietor?:No
Enumeration Date:2017-03-26
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME143932208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics