NPIMap

Organization Active NPI

Lisa M Disanto DO PA

  • Family Medicine Physician
  • St Petersburg, FL
National Provider Identifier
1750680807
Registry record updated Mar 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS5732 Issued in FL
Legal business name
LISA M DISANTO DO PA
Practice address
6776 54TH Ave N
Suite a
St Petersburg, FL 33709-1405
Phone
(727) 548-8500
Fax
(727) 548-9800
NPI assigned
Mar 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2011

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

Authorized official

Name
Dr. Lisa M Disanto, DO
Title
President
Phone
(727) 548-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X OS5732 FL Primary

Addresses

Primary practice location

6776 54TH Ave N
Suite a
St Petersburg, FL 33709-1405

Mailing address

6776 54TH Ave N
Suite a
St Petersburg, FL 33709-1405
Phone (727) 548-8500

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1300147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300147200000",
    "number": "1750680807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6776 54TH AVE N",
            "address_2": "SUITE A",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337091405",
            "telephone_number": "727-548-8500",
            "fax_number": "727-548-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6776 54TH AVE N",
            "address_2": "SUITE A",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337091405",
            "telephone_number": "727-548-8500",
            "fax_number": "727-548-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA M DISANTO DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-15",
        "last_updated": "2011-03-15",
        "status": "A",
        "authorized_official_last_name": "DISANTO",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-548-8500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS5732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2011; 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.