Provider Demographics
NPI:1346771086
Name:NEUFELD, LISA ANN (ARNP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:NEUFELD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 S OSPREY AVE
Mailing Address - Street 2:STE 1
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2900
Mailing Address - Country:US
Mailing Address - Phone:941-366-9060
Mailing Address - Fax:941-953-7076
Practice Address - Street 1:1425 S OSPREY AVE, SUITE 1
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-6014
Practice Address - Country:US
Practice Address - Phone:941-366-9060
Practice Address - Fax:941-953-7076
Is Sole Proprietor?:No
Enumeration Date:2017-03-24
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN1848082363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103185900Medicaid