Individual provider Active NPI

Lisa Santiago, APRN, BC

  • Adult Health Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1124208558
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN1103226 Issued in FL
Practice address
5555 E Michigan St Ste 104
Orlando, FL 32822-2700
Phone
(407) 412-5567
NPI assigned
Nov 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP3457 AZ
Adult Health Nurse Practitioner 363LA2200X APRN1103226 FL Primary

Addresses

Primary practice location

5555 E Michigan St Ste 104
Orlando, FL 32822-2700

Mailing address

5555 E Michigan St Ste 104
Orlando, FL 32822-2700
Phone (407) 412-5567

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140521000089 AZ Order and Referring Only - Nurse Practitioner 4981788841

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN1103226FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Injury Care LLC Nurse Practitioner CurrentSince Aug 18, 2024 Accepting new patients
Eric Baumann MD, PC PastSince Jul 1, 2005 Accepting new patients

Locations

5555 E Michigan St
Ste 104
Orlando, FL 32822
Phone (407) 412-5567

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1124208558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 E MICHIGAN ST STE 104",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328222700",
            "telephone_number": "407-412-5567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 E MICHIGAN ST STE 104",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328222700",
            "telephone_number": "407-412-5567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "LISA",
        "credential": "APRN, BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-14",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP3457",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN1103226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.