Provider Demographics
NPI:1962673863
Name:PARENTI, LISA CAROL (DC)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:CAROL
Last Name:PARENTI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:LISA
Other - Middle Name:CAROL
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:200 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:SATELLITE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-3371
Mailing Address - Country:US
Mailing Address - Phone:615-394-7711
Mailing Address - Fax:321-234-9217
Practice Address - Street 1:1110 HWY A1A
Practice Address - Street 2:
Practice Address - City:SATELLITE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-2409
Practice Address - Country:US
Practice Address - Phone:321-765-5777
Practice Address - Fax:321-234-9217
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-18
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN706111N00000X
FLCH9733111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor