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General NPI Number Information
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NPI Number | 1497469134
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Entity Type | Individual
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Provider Name | DR. LOUIS ROBERTO BISONO
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Gender | Male
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Dates
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Enumeration Date | 01/09/2023
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 601 E ROLLINS ST
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City | ORLANDO
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State | FL
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Zip | 32803-1248
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Country | US
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Telephone | 407-846-0023
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Fax |
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Provider Business Mailing Address
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Address Line | 601 E ROLLINS ST
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City | ORLANDO
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State | FL
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Zip | 32803-1248
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Country | US
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Telephone | 407-303-5600
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number | PN5189468
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 364SP0810X
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Taxonomy Name | Child & Family Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | PN5189468
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | TRN42144
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License Number State | FL
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