Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lisandro Roberto Fortuny

Individual provider Clinical Pathology Physician · NPI 1104479203

Lisandro Roberto Fortuny is a Pathology in Saint Louis, Missouri. Qualified in 2007, 19 years ago. Licensed in Georgia, Illinois and Missouri.

Years since qualifying
19
Licensed in
GA, IL, MO
In the registry since
2019
Specialties on file
3
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Practice location Address checks out

1 Barnes Jew Hosp Plz
Saint Louis, MO 63110-1003
Phone: (314) 362-5000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Blood Banking & Transfusion Medicine Physician (primary) Taxonomy 207ZB0001X · Licence 97756 (GA)
Clinical Pathology Physician Taxonomy 207ZC0006X · Licence 036-161400 (IL)
Clinical Pathology/Laboratory Medicine Physician Taxonomy 207ZP0105X · Licence 2019018934 (MO)

Record details

NPI number1104479203
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 18, 2019
Last updated in NPPESOctober 7, 2025
Certification dateOctober 7, 2025
Mailing address660 S Euclid Ave # 8118, Saint Louis, MO 63110-1010

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPATHOLOGY
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

Other providers in Saint Louis