Individual provider Active NPI

Lisa Kristen Mello, COTA

  • Occupational Therapy Assistant
  • Lake Mary, FL
National Provider Identifier
1497963508
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
721 Issued in CA
Practice address
250 International Pkwy
Suite 260
Lake Mary, FL 32746-5030
Phone
(800) 509-5872
NPI assigned
May 21, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OC00001187 WA
Occupational Therapy Assistant 224Z00000X 721 CA Primary

Addresses

Primary practice location

250 International Pkwy
Suite 260
Lake Mary, FL 32746-5030

Mailing address

27190 Stark St
Sun City, CA 92586-2045
Phone (619) 508-4066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OC00001187WAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1497963508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27190 STARK ST",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925862045",
            "telephone_number": "619-508-4066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 INTERNATIONAL PKWY",
            "address_2": "SUITE 260",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465030",
            "telephone_number": "800-509-5872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLO",
        "first_name": "LISA",
        "middle_name": "KRISTEN",
        "name_prefix": "Ms.",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WA",
            "license": "OC00001187",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.