Lisandra Annette Indomenico, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10680 Issued in PR

Practice address

111 E Monument Ave Unit 509
Kissimmee, FL 34741-5779

Phone

(407) 460-7850

NPI assigned

Dec 7, 2011

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1323216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349481600000",
    "number": "1700154671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E MONUMENT AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E MONUMENT AVE UNIT 509",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415779",
            "telephone_number": "407-460-7850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INDOMENICO",
        "first_name": "LISANDRA",
        "middle_name": "ANNETTE",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-07",
        "last_updated": "2012-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PR",
            "license": "10680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Infectious Disease Specialists of Central Florida , PA

• Clinical Social Worker in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2012; 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.