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1740211325
LISA M POTTHAST
TAMPA, FL
NPI
1740211325
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: FL PA912742)
Enumeration Date
2006-07-05
Last Update Date
2007-12-28
Business Address
-- LISA M POTTHAST PA
12902 USF MAGNOLIA DR MDC 44
TAMPA, FL 33612-9416
Phone number: 813-745-3200
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Mailing Address
-- LISA M POTTHAST PA
PO BOX 917770
ORLANDO, FL 32891-7770
Phone number:
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