Mrs Lisa Waggoner Barker, MD | |
2061 Collier Pkwy, Land O Lakes, FL 34639-5202 | |
(727) 845-5707 | |
(813) 501-8250 |
Full Name | Mrs Lisa Waggoner Barker |
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Gender | Female |
Speciality | Surgery - Hospice And Palliative Medicine |
Location | 2061 Collier Pkwy, Land O Lakes, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1205807500 | NPI | - | NPPES |
000000045747 | Other | BLUE CROSS AND BLUE SHIELD | |
000000583695 | Other | BLUE CROSS AND BLUE SHIELD | |
64306160 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 30616 (Kentucky) | Secondary |
2086H0002X | Surgery - Hospice And Palliative Medicine | ME128980 (Florida) | Primary |
Entity Name | Gulfside Palliative Care, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1750531489 PECOS PAC ID: 3678611837 Enrollment ID: O20091109000107 |
Mailing Address | Practice Location Address |
---|---|
Mrs Lisa Waggoner Barker, MD 2061 Collier Pkwy, Land O Lakes, FL 34639-5202 Ph: (727) 845-5707 | Mrs Lisa Waggoner Barker, MD 2061 Collier Pkwy, Land O Lakes, FL 34639-5202 Ph: (727) 845-5707 |
Dr. Olumide Ijishakin, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 17289 Hackberry Sq Apt 211, Land O Lakes, FL 34638 Phone: 323-363-8489 | |
Dr. Lou E Macmanus, D.O. Surgery Medicare: Not Enrolled in Medicare Practice Location: 2609 20 Mile Level Rd, Land O Lakes, FL 34639 Phone: 813-949-5325 Fax: 813-949-5325 |