Provider Demographics
NPI:1649626409
Name:LASANTA, JAHAIRA ELIZABETH (ARNP)
Entity type:Individual
Prefix:MS
First Name:JAHAIRA
Middle Name:ELIZABETH
Last Name:LASANTA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15275 COLLIER BLVD STE 201-165
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-6750
Mailing Address - Country:US
Mailing Address - Phone:786-256-4252
Mailing Address - Fax:786-590-1618
Practice Address - Street 1:2328 HANCOCK BRIDGE PKWY STE 101A
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-1455
Practice Address - Country:US
Practice Address - Phone:239-652-3783
Practice Address - Fax:239-652-3881
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-11
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61082877363LF0000X
FLARNP9258602363LF0000X
VA24190140363LF0000X
PASP021868363LF0000X
VT101.0137172363LF0000X
TN36306363LF0000X
TX1133303363LF0000X
NY351607363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102208400Medicaid