MEDICARE: LISANNE MARIE CHIOTA FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	9416787	FL
2	363LF0000X	Family Nurse Practitioner	R107506	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437265378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISANNE MARIE CHIOTA FNP

Provider Business Mailing Address
First Line	:	17130 SE 91ST LEE AVE
Second Line	:
City	:	THE VILLAGES
State	:	FL
Zip	:	32162-1823
Country	:	US
Telephone Number	:	301-980-1075
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 E HWY 50
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-1914
Country	:	US
Telephone Number	:	866-389-2727
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	10/19/2015

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