Individual provider · Type 1 NPI

Don Anton Dayantha Wisidagama, PA

Medical Physician Assistant · Lake Mary, FL

NPI number 1437628260 Active

Practice location

725 Rodel Cv
Lake Mary, FL 32746-4859

Call (407) 302-3130 Map

Fax (407) 302-3132

Other practice locations

  • 253 Sumner Pl, Staten Island, NY 10301-2835 · (347) 636-6950

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA9113883 (FL)
Physician Assistant 363A00000XNone listed

Medical Physician Assistant: Definition to come...

19 other providers at this address

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About NPI 1437628260

Don Anton Dayantha Wisidagama, PA's National Provider Identifier is 1437628260, issued on Nov 22, 2018. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Lake Mary, FL. The record was last updated on Apr 10, 2026.