| Carlisa Family Medical And Aesthetics Llc | |
|
4409 Sun N Lake Blvd Ste F Sebring FL 33872-2170 | |
| (615) 772-5480 | |
| Not Available |
| Full Name | Carlisa Family Medical And Aesthetics Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4409 Sun N Lake Blvd Ste F, Sebring, Florida |
| Authorized Official Name and Position | Lisa Ann Motteler (OWNER) |
| Authorized Official Contact | 6157725480 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carlisa Family Medical And Aesthetics Llc 2301 Mangrove Rd Punta Gorda FL 33982-3339 Ph: (615) 772-5480 | Carlisa Family Medical And Aesthetics Llc 4409 Sun N Lake Blvd Ste F Sebring FL 33872-2170 Ph: (615) 772-5480 |
| NPI Number | 1871236166 |
|---|---|
| Provider Enumeration Date | 04/15/2022 |
| Last Update Date | 04/15/2022 |
| Medicare PECOS PAC ID | 1052790490 |
|---|---|
| Medicare Enrollment ID | O20220615002277 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871236166 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Lisa Ann Motteler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770234437 PECOS PAC ID: 1557749082 Enrollment ID: I20220611000108 |
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