Provider Demographics
NPI:1568586337
Name:BISSESSAR, LISA (OD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:BISSESSAR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:3402 TECHNOLOGICAL AVE
Mailing Address - Street 2:SUITE 124
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-1402
Mailing Address - Country:US
Mailing Address - Phone:407-208-1890
Mailing Address - Fax:407-208-1877
Practice Address - Street 1:3402 TECHNOLOGICAL AVE
Practice Address - Street 2:SUITE 124
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-1402
Practice Address - Country:US
Practice Address - Phone:407-208-1890
Practice Address - Fax:407-208-1877
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOPC3871152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL16919OtherAVESIS
FL2001559460OtherWELLCARE HMO
FL09298OtherMEDICAL EYE SERVICES
FL201559450OtherADVANTICA EYE CARE
FL201559460OtherCITRUS MEDICARE
FL201559460OtherSUPERIOR VISION
FL59396OtherSAFEGUARD PPO
FL201559460OtherCITRUS HEALTH CARE
FL201559460OtherGREAT WEST
FL201559460OtherPREFERRED ONE ADMIN
FL222104OtherCOLE VISION
FL24570OtherSPECTERA
FL44732OtherDAVIS VISION
FL13734OtherSVS FORD
FL921486OtherBLOCK VISION
FL201559460OtherSTAYWELL HEALTHY KIDS
FL100724OtherNVA
FL201559460OtherALLIED EYE CARE
FL201559460OtherCARE ONE
FL201559460OtherPREFERRED ONE ADMIN