Active NPI
Lisa Diquollo
- Massage Therapist
- Orlando, FL
National Provider Identifier
1942536305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA42355
- Practice address
- 1910 Alden Rd
Orlando, FL 32803-1403 - Phone
- (407) 898-7911
- Fax
- (407) 898-7912
- NPI assigned
- Oct 20, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA42355 | FL | Primary |
Addresses
Primary practice location
1910 Alden Rd
Orlando, FL 32803-1403
Mailing address
127 W Fairbanks Ave
No. 240
Winter Park, FL 32789-4326
Phone (407) 312-7876
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA42355 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1255996800000",
"number": "1942536305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "127 W FAIRBANKS AVE",
"address_2": "NO. 240",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327894326",
"telephone_number": "407-312-7876"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1910 ALDEN RD",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328031403",
"telephone_number": "407-898-7911",
"fax_number": "407-898-7912"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIQUOLLO",
"first_name": "LISA",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-10-20",
"last_updated": "2009-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA42355",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.