| Lisa Brice | |
|
248 Southpark Circle East Saint Augustine FL 32086 | |
| (904) 797-5680 | |
| Not Available |
| Full Name | Lisa Brice |
|---|---|
| Speciality | Social Worker |
| Location | 248 Southpark Circle East, Saint Augustine, Florida |
| Authorized Official Name and Position | Kris Miller (OFFICE MANAGER) |
| Authorized Official Contact | 9047975680 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Brice 248 Southpark Cir E Saint Augustine FL 32086-5137 Ph: (904) 797-5680 | Lisa Brice 248 Southpark Circle East Saint Augustine FL 32086 Ph: (904) 797-5680 |
| NPI Number | 1336683663 |
|---|---|
| Provider Enumeration Date | 12/06/2016 |
| Last Update Date | 12/06/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336683663 | NPI | - | NPPES |
| 1548715329 | Other | FL | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | SW13171 (Florida) | Primary |
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