| NPI | 1811360092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MICHELLE HIESTAND A RN P C 863-844-1636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 2011842) |
| Enumeration Date | 2015-11-10 |
| Last Update Date | 2015-11-10 |