TANYA M MEDINA (NPI# 1023069960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023069960 |
| Entity Type | Individual |
| Full Name | TANYA M MEDINA |
| Credential | MD |
| Practice Address |
618 13th St Ste A Saint Cloud FL 34769-4503 |
| Mailing Address |
618 13th St Stea Saint Cloud FL 34769-4503 |
| Practice Telephone | 4075563999 |
| Practice Fax Number | 4075563933 |
| Mailing Telephone | 4075563999 |
| Mailing Fax Number | 4075563933 |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2010-05-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | ME84474 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 270733100 | 05 |
| Street Address |
618 13TH ST STE A |
| City | SAINT CLOUD |
| State | FL |
| Zip Code | 34769-4503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053877506 | Premier Med Pa | Clinic/Center | 2906 17th St., St Cloud, FL 34769 | 2019-02-20 |
| 1760975387 | Mayra Rosado | Psychologist | Carrousel Therapy Center, 3201 Budinger Ave., Saint Cloud, FL 34769 | 2018-06-08 |
| 1598282113 | Salud Urgent Care LLC | Clinic/Center | 3107 13th Street, Saint Cloud, FL 34769 | 2017-08-24 |
| 1710332671 | American Healthcare Community Behavioral Services LLC | Social Worker | 1203 Florida Ave., St. Cloud, FL 34769 | 2016-04-28 |
| 1215395785 | Elite Garden | Assisted Living Facility | 4319 Neptune Road, St Cloud, FL 34769 | 2016-01-29 |
| 1336506732 | Adventist Health System/sunbelt, Inc. | Clinic/Center | 4660 13th Street, St. Cloud, FL 34769 | 2016-01-15 |
| 1306202064 | Megan Rose Mcclave | Registered Nurse | 524 13th Street, St. Cloud, FL 34769 | 2016-01-12 |
| 1821473133 | Angela Creager | Counselor | 446 Hamilton Park Circle, St. Cloud, FL 34769 | 2015-07-28 |
| 1730574906 | Jordico LLC | Assisted Living Facility | 4417 13th Street, Suite 142, Saint Cloud, FL 34769 | 2015-04-03 |
| 1255731667 | Judimar Rodriguez | Behavioral Analyst | 1605 Eastern Ave, Saint Cloud, FL 34769 | 2014-09-04 |
| Find all providers in zip 34769 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780186486 | Simplicity Health Pa | Family Medicine | 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 | 2018-03-08 |
| 1851825343 | Adventist Health System/sunbelt, Inc. | Family Medicine | 4660 13th St, Saint Cloud, FL 34769-6765 | 2017-04-12 |
| 1871045377 | Anthony Joseph Picconatto | Family Medicine | 1900 Centracare Cir Ste 1450, Saint Cloud, MN 56303-5000 | 2016-10-31 |
| 1093195489 | Olufunke O Ajayi | Family Medicine | Centracare Clinic St Cloud Medical Group South, 1301 33rd St S, Saint Cloud, MN 56301-9668 | 2015-06-01 |
| 1417180043 | Premier Life Health Services, LLC | Family Medicine | 4737 Old Canoe Creek Road, Saint Cloud, FL 34769-0000 | 2009-08-31 |
| 1023269438 | Elba Ener Masid | Family Medicine | 4513 Old Canoe Creek Rd, Saint Cloud, FL 34769-1551 | 2008-10-03 |
| 1124211164 | Access Pronto Family Medicine P A | Family Medicine | 2918 17th St, Saint Cloud, FL 34769-6018 | 2007-08-23 |
| 1205856705 | Ahmed Quaye Aidoo | Family Medicine | 3501 13th St, Saint Cloud, FL 34769-4054 | 2006-07-20 |
| 1437106986 | Clarice Hanks Konshok | Family Medicine | 1555 Northway Dr Ste 200, Saint Cloud, MN 56303-4913 | 2006-05-30 |
| 1811949415 | Carmen Ana Sierra | Family Medicine | 4741 Old Canoe Creek Rd, Saint Cloud, FL 34769-1400 | 2006-05-16 |
| Find all providers in SAINT CLOUD | ||||
| City | SAINT CLOUD |
| Zip Code | 34769 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.