Provider Demographics
NPI:1558382960
Name:SINGH, DALISAY N (APRN)
Entity Type:Individual
Prefix:
First Name:DALISAY
Middle Name:N
Last Name:SINGH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18928 NORTH DALE MABRY HIGHWAY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33548-4922
Mailing Address - Country:US
Mailing Address - Phone:813-909-1146
Mailing Address - Fax:813-909-4334
Practice Address - Street 1:11347 VILLAGE BROOK DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33579-7191
Practice Address - Country:US
Practice Address - Phone:813-252-6646
Practice Address - Fax:813-252-6646
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9379570363L00000X
FLAPRN9379570363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P02754Medicare UPIN
CT500000413Medicare ID - Type Unspecified