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1114997616
LISA GONSALVES
ORMOND BEACH, FL
NPI
1114997616
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: FL ME0060521)
Enumeration Date
2006-01-25
Last Update Date
2012-06-21
Business Address
-- LISA GONSALVES M.D.
335 CLYDE MORRIS BLVD SUITE 240
ORMOND BEACH, FL 32174-3181
Phone number: 386-231-3561
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Mailing Address
-- LISA GONSALVES M.D.
PO BOX 730729
ORMOND BEACH, FL 32173-0729
Phone number: 386-231-3561
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