Provider Demographics
NPI:1730178286
Name:CHRISS, LISA WEBER (MD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:WEBER
Last Name:CHRISS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1925 MIZELL AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-4106
Mailing Address - Country:US
Mailing Address - Phone:407-629-6646
Mailing Address - Fax:407-740-5089
Practice Address - Street 1:1925 MIZELL AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-4106
Practice Address - Country:US
Practice Address - Phone:407-629-6646
Practice Address - Fax:407-740-5089
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME73116207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252894100Medicaid
FL68858OtherBCBS INDIVIDUAL ID #
FL68858OtherBCBS INDIVIDUAL ID #