Individual provider Active NPI

Darvis Eduardo Dager Lissabet, MD

  • General Practice Physician
  • Cape Coral, FL
National Provider Identifier
1720765506
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN1654 Issued in FL
Practice address
2301 Del Prado Blvd S Ste 890
Cape Coral, FL 33990-6609
Phone
(239) 574-8880
NPI assigned
Jul 3, 2023
Last updated
Jul 7, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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 ACN1654 FL Primary

Addresses

Primary practice location

2301 Del Prado Blvd S Ste 890
Cape Coral, FL 33990-6609

Mailing address

601 S Harbour Island Blvd Ste 200
Tampa, FL 33602-5925
Phone (727) 322-3439

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
I20241028003072 FL Practitioner - General Practice 9335672419 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
University of Puerto Rico School of Dentistry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prime Life Health LLCGroup PAC ID 5092153940, 4 clinicians
Revitalize Health Center LLCGroup PAC ID 1052800299, 5 clinicians

Practice addresses (Care Compare)

3411 W Tampa Bay Blvd
Tampa, FL 33607-6619
Phone (813) 874-1509

5285 Summerlin Rd
Suite 101
Fort Myers, FL 33919-7601
Phone (239) 291-6633

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1654FLMDGeneral Practice Physician
16810PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primelife Health LLC CurrentSince Sep 21, 2024 Accepting new patients
Revitalize Health Center LLC General Practice CurrentSince Jan 18, 2026 Accepting new patients
Primelife Health LLC CurrentSince Sep 21, 2024 Accepting new patients
Florida Medical Associates LLC Past Accepting new patients

Locations

2621 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 220-5561

433 SW 10th St
Ocala, FL 34471
Phone (352) 436-4545

3411 W Tampa Bay Blvd
Tampa, FL 33607
Phone (813) 466-4678

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JAFDDD

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1720765506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S HARBOUR ISLAND BLVD STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336025925",
            "telephone_number": "727-322-3439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 DEL PRADO BLVD S STE 890",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339906609",
            "telephone_number": "239-574-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGER LISSABET",
        "first_name": "DARVIS",
        "middle_name": "EDUARDO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-03",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN1654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.