Active NPI
Lisandra Maldonado, APRN
- Family Nurse Practitioner
- Melbourne, FL
National Provider Identifier
1265374672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 11046564
- Practice address
- 1350 Hickory St
Melbourne, FL 32901-3224 - Phone
- (321) 434-7000
- NPI assigned
- Apr 6, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 11046564 | FL | Primary |
Addresses
Primary practice location
1350 Hickory St
Melbourne, FL 32901-3224
Mailing address
124 Haines Rd SW
Palm Bay, FL 32908-1337
Phone (954) 716-2909
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11046564 | FL | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1775433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775433600000",
"number": "1265374672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 HAINES RD SW",
"city": "PALM BAY",
"state": "FL",
"postal_code": "329081337",
"telephone_number": "954-716-2909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 HICKORY ST",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329013224",
"telephone_number": "321-434-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALDONADO",
"first_name": "LISANDRA",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-04-06",
"last_updated": "2026-04-06",
"certification_date": "2026-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "11046564",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.