Organization Active NPI

Martin L Lesin DC PA

  • Chiropractor
  • Port St Lucie, FL
National Provider Identifier
1912022526
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0002815 Issued in FL
Legal business name
MARTIN L LESIN DC PA
Practice address
1967 SE Port St Lucie Blvd
Port St Lucie, FL 34952
Phone
(772) 335-3110
Fax
(772) 398-0704
NPI assigned
Mar 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

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

Authorized official

Name
Dr. Martin L Lesin, DC
Title
Chiropractic Physician Owner
Phone
(772) 335-3110

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH0002815 FL Primary

Addresses

Primary practice location

1967 SE Port St Lucie Blvd
Port St Lucie, FL 34952

Mailing address

1967 SE Port St Lucie Blvd
Port St Lucie, FL 34952
Phone (772) 335-3110

Other identifiers 1

IdentifierTypeStateIssuer
55715OtherBLUE CROSS BLUE SHIELD FL

National Provider Directory

National Provider Directory

Locations

1967 SE Port St Lucie Blvd
Port St Lucie, FL 34952
Phone (772) 335-3110

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196812800000",
    "number": "1912022526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1967 SE PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "34952",
            "telephone_number": "772-335-3110",
            "fax_number": "772-398-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1967 SE PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "34952",
            "telephone_number": "772-335-3110",
            "fax_number": "772-398-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN L LESIN DC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-12-05",
        "status": "A",
        "authorized_official_last_name": "LESIN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN OWNER",
        "authorized_official_telephone_number": "772-335-3110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0002815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD FL",
            "identifier": "55715",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; 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.