LISA MARIE SERVICE PA-C
NPI 1598031015
Physician Assistant - Medical in Miami Lakes, FL

Q: What is Lisa Service's NPI number?

The NPI number for Lisa Service is 1598031015. It was assigned to this individual provider in the NPPES registry on March 29, 2012. The provider is also known as Lisa Marie Clarke Pa-C.

Q: What is Lisa Service's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Lisa Service was last updated on August 16, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 29, 2012

15507 NW 67TH AVE, MIAMI LAKES, FL 33014(305) 821-8611(305) 827-1753 Get Directions Write a Review

NPPES record last updated: August 16, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 16, 2019, Jul 26, 2019 (2 updates tracked since 2019).

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About Lisa Marie Service Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LISA MARIE SERVICE PA-C (NPI 1598031015) is an individual medical provider in Miami Lakes, Florida, licensed in Florida (9105791) and active in the NPI registry since March 2012.

NPPES Registry Identity

NPI1598031015

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameLISA MARIE SERVICECredential: PA-C

Location Address15507 NW 67TH AVEMiami Lakes, FL 33014-2108

Mailing Address900 S Pine Island RdPlantation, FL 33324-3920 · (305) 821-8611 · Fax (305) 827-1753

Phone(305) 821-8611

Fax(305) 827-1753

Sole ProprietorNo

Enumeration DateMarch 29, 2012

Last NPPES UpdateAugust 16, 20192 updates tracked since enumeration

✔ NPI 1598031015 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in FL · 9105791

Also ListedCommunity Health WorkerTaxonomy 172V00000X · License 9105791 (FL)

15507 NW 67TH AVE, Miami Lakes, FL 33014

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Other Names 1

Former Name (1)Lisa Marie Clarke Pa-c

Other Identifiers 1

Medicaid007661300FL

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JUSTIN PARKER JETER M.D.

Pediatrics