Healthcare Provider Details

I. General information

NPI: 1730456369
Provider Name (Legal Business Name): LISA MARIE GENOVESE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2011
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 66TH ST N STE 202
PINELLAS PARK FL
33781-2101
US

IV. Provider business mailing address

7800 66TH ST N STE 202
PINELLAS PARK FL
33781-2101
US

V. Phone/Fax

Practice location:
  • Phone: 727-477-2988
  • Fax: 727-516-4788
Mailing address:
  • Phone: 727-477-2988
  • Fax: 727-516-4788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9233666
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: