Healthcare Provider Details

I. General information

NPI: 1295257459
Provider Name (Legal Business Name): LISA CASINGAL ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2017
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1605 W FAIRBANKS AVE
WINTER PARK FL
32789-4603
US

IV. Provider business mailing address

1605 W FAIRBANKS AVE
WINTER PARK FL
32789-4603
US

V. Phone/Fax

Practice location:
  • Phone: 407-845-8356
  • Fax:
Mailing address:
  • Phone: 407-845-8356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number2222112
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: