Individual provider Active NPI

Juan Alberto Martin Lissabet, MD

  • General Practice Physician
  • Kissimmee, FL
National Provider Identifier
1649332792
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN955 Issued in FL
Practice address
900 Towne Center Dr
Kissimmee, FL 34759-3470
Phone
(407) 931-0444
Fax
(407) 962-4446
NPI assigned
Dec 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ACN955 FL Primary

Addresses

Primary practice location

900 Towne Center Dr
Kissimmee, FL 34759-3470

Mailing address

931 W Oak St Ste 103
Kissimmee, FL 34741-4973
Phone (407) 931-0444

Other practice location 1

931 W Oak St Ste 103
Kissimmee, FL 34741-4973
Phone (407) 931-0444

Other practice location 2

2330 North Blvd W
Davenport, FL 33837-8989
Phone (407) 931-0444

Other practice location 3

1115 N John Young Pkwy
Kissimmee, FL 34741-4209
Phone (407) 931-0444

Other practice location 4

2685 SW 32nd Pl Ste 100
Ocala, FL 34471-7863
Phone (407) 931-0444

Other practice location 5

6210 W Colonial Dr Ste 100
Orlando, FL 32808-7504
Phone (407) 931-0444

Other practice location 6

3130 Citrus Tower Blvd
Clermont, FL 34711-6801
Phone (407) 931-0444

Other practice location 7

5425 S Semoran Blvd Ste 7C
Orlando, FL 32822-1777
Phone (407) 931-0444

Other practice location 8

5249 Conway Rd
Orlando, FL 32812-2202
Phone (407) 931-0444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211216001999 FL Practitioner - General Practice 9931090636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Family Medical IncGroup PAC ID 7416055454, 36 clinicians

Practice addresses (Care Compare)

900 Towne Ctr Dr
Kissimmee, FL 34759-3470
Phone (407) 931-0444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ACN955FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Home Alliance LLC CurrentSince Oct 3, 2022 Accepting new patients
Medical Home Alliance LLC Past Accepting new patients
Orlando Family Medical Inc General Practice PastSince Aug 1, 2021 Accepting new patients
Tampa Family Health Centers Inc Past Accepting new patients
Orlando Family Medical Inc General Practice PastSince Aug 1, 2021 Accepting new patients

Locations

684 State Road 60 W
Lake Wales, FL 33853
Phone (863) 949-4668

6675 Westwood Blvd
Ste 475
Orlando, FL 32821
Phone (407) 845-0384

Organizations & group practices 6

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": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1649332792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 W OAK ST STE 103",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414973",
            "telephone_number": "407-931-0444",
            "fax_number": "407-962-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 TOWNE CENTER DR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347593470",
            "telephone_number": "407-931-0444",
            "fax_number": "407-962-4446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "931 W Oak St Ste 103",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347414973",
            "country_code": "US",
            "telephone_number": "407-931-0444",
            "fax_number": "407-962-4446",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2330 North Blvd W",
            "address_purpose": "LOCATION",
            "city": "Davenport",
            "state": "FL",
            "postal_code": "338378989",
            "country_code": "US",
            "telephone_number": "407-931-0444",
            "fax_number": "407-962-4446",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1115 N John Young Pkwy",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347414209",
            "country_code": "US",
            "telephone_number": "407-931-0444",
            "fax_number": "407-962-4446",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2685 SW 32nd Pl Ste 100",
            "address_purpose": "LOCATION",
            "city": "Ocala",
            "state": "FL",
            "postal_code": "344717863",
            "country_code": "US",
            "telephone_number": "407-931-0444",
            "fax_number": "407-962-4446",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6210 W Colonial Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328087504",
            "country_code": "US",
            "telephone_number": "407-931-0444",
            "fax_number": "407-962-4446",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3130 Citrus Tower Blvd",
            "address_purpose": "LOCATION",
            "city": "Clermont",
            "state": "FL",
            "postal_code": "347116801",
            "country_code": "US",
            "telephone_number": "407-931-0444",
            "fax_number": "407-962-4446",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5425 S Semoran Blvd Ste 7C",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328221777",
            "country_code": "US",
            "telephone_number": "407-931-0444",
            "fax_number": "407-962-4446",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5249 Conway Rd",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328122202",
            "country_code": "US",
            "telephone_number": "407-931-0444",
            "fax_number": "407-962-4446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN LISSABET",
        "first_name": "JUAN",
        "middle_name": "ALBERTO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.