Lisa Marie Derosimo, MD MS

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME 56721 Issued in FL

Practice address

11535 SW 88TH St
Miami, FL 33176-1002

Phone

(786) 595-8000

Fax

(786) 533-9576

NPI assigned

Apr 4, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434585600000",
    "number": "1013039643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11535 SW 88TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331761002",
            "telephone_number": "786-595-8000",
            "fax_number": "786-533-9576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11535 SW 88TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331761002",
            "telephone_number": "786-595-8000",
            "fax_number": "786-533-9576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSIMO",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2015-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 56721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dermatology Network Solutions of Florida, LLC
• Dermatology Network Solutions, LLC
• Elyse Dermer
• Harrison Dermer, MD
• John Derosimo, MD
• Taylor Sky Derris, M.S. CFY SLP
• Ruth Dervil
• Des Mobile Diagnostics Imaging Inc
• Desad, Inc.
• Anshumi Janak Desai, M.D.

• Family Medicine Physician in Miami, FL
• Providers in Miami, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.