Wesly J Lisme

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

TPPA452 Issued in FL

Practice address

1426 Bloomingdale Ave
Valrico, FL 33596-6110

Phone

(813) 684-8020

Fax

(813) 684-8206

NPI assigned

Mar 31, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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": "1680220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1871298844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 LAKE EMERALD DR APT 202",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333096205",
            "telephone_number": "954-479-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1426 BLOOMINGDALE AVE",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335966110",
            "telephone_number": "813-684-8020",
            "fax_number": "813-684-8206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISME",
        "first_name": "WESLY",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-31",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PR",
            "license": "1367PA",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PR",
            "license": "1367PA",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "TPPA452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Light of Hope Counseling Services LLC
• Kathleen Likar, ARNP
• Sharmila Lilland, APRN
• Eric Chua Lim, DPT
• Trevor S Lint
• Rebecca Leigh Lorraine, ARNP
• Shae Elyce Loucks, LCSW
• Louisana Louis, PMHNP-BC
• Tyler Bradney Love, PT, DPT
• Lovebirth, LLC

• Physician Assistant in Valrico, FL
• Providers in Valrico, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; 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.