CARLOS MEDINA MD PA (NPI# 1700242617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1700242617 |
Entity Type | Organization |
Organization Name | CARLOS MEDINA MD PA |
Practice Address |
11760 Bird Rd Ste 606 Miami FL 33175-8100 |
Mailing Address |
1101 Waterside Ln Hollywood FL 33019-5005 |
Practice Telephone | 7868177808 |
Enumeration Date | 2016-01-07 |
Last Update Date | 2020-08-13 |
Authorized Official Name | CARLOS MEDINA (OWNER) |
Authorized Official Telephone | 7868177808 |
Authorized Official Credential | M.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
ME106831 | FL | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | MEDICAL LICENSE | ME106831 | 01 |
Street Address |
11760 BIRD RD STE 606 |
City | MIAMI |
State | FL |
Zip Code | 33175-8100 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487895124 | Carlos Reydell Medina | Plastic Surgery | 11760 Bird Rd Ste 606, Miami, FL 33175-8100 | 2009-03-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548885965 | Kevin Bernardo Gonzalez | Behavior Technician | 11895 Sw 37 St, Miami, FL 33175 | 2020-06-11 |
1619509106 | Gladysbel Lorenzo | Nurse Practitioner | 11740 Sw 42st, Miami, FL 33175 | 2020-02-12 |
1154885200 | Vanessa Arzola Dmd Pa and Associates | Clinic/Center | 13419 Sw 56th Street, Miami, Miami, FL 33175 | 2019-01-23 |
1588145932 | Mailen Gonzalez | Nurse Practitioner | 12294 Sw 29 Ter, Miami, FL 33175 | 2018-08-23 |
1639655350 | Carolina Marie Trueba | Behavior Technician | 12825 Sw 49th Terr, Miami, FL 33175 | 2018-07-16 |
1033611504 | Joan Coro | Behavior Technician | 12905 Sw 42nd St Suite 219, Miami, FL 33175 | 2018-03-01 |
1417456864 | Ignacio Alzugaray | Nurse Practitioner | 12317 Sw 20th Ter, Miami, FL 33175 | 2018-02-12 |
1215436993 | Desiree Rengifo-glasgow | Nurse Practitioner | 11865 Sw 26th St Ste J2, Miami, FL 33175 | 2018-02-07 |
1639678691 | Behavior Professional Consultants Corp. | Community/Behavioral Health | 2460 Sw 137th Ave 242, Miami, FL 33175 | 2018-02-06 |
1992204291 | Humberto Lorenzo Paez | Nurse Practitioner | 4205 Sw 136th Place, Miami, FL 33175 | 2018-02-02 |
Find all providers in zip 33175 |
Taxonomy Code | 2086S0122X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Plastic and Reconstructive Surgery |
A surgeon who specializes in plastic and reconstructive surgery. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952561763 | Juan Rodolfo Mella-catinchi | Surgery | 1120 Nw 14th St Fl 4r310, Miami, FL 33136-2107 | 2008-06-15 |
1508880733 | Deirdre Margaret Marshall | Surgery | 6360 Sunset Dr, Miami, FL 33143-4836 | 2006-07-27 |
1194758078 | Constantine Nicholas Kitsos | Surgery | 9000 Ne 2nd Ave, Miami, FL 33138 | 2006-07-07 |
1447299722 | Alan Sherwin Rapperport | Surgery | 6280 Sunset Drive, Unit 501, Miami, FL 33143 | 2006-06-05 |
1639708589 | Zuri Plastic Surgery | Surgery | 8585 Sw 72nd St Ste 107, Miami, FL 33143-3746 | 2020-04-03 |
1770134231 | Samira Caraballo | Surgery | 8900 N Kendall Dr, Miami, FL 33176-2118 | 2019-09-26 |
1609309491 | Anne-sophie Lessard | Surgery | 1120 Nw 14th St, Crb 4th Floor, Miami, FL 33136 | 2017-04-07 |
1730580457 | John C Oeltjen, Md, LLC | Surgery | 8740 Sw 88th St, Suite 218, Miami, FL 33176-2212 | 2014-09-12 |
1588000335 | Lauren Michelle Yarholar | Surgery | 1120 Nw 14th St, Miami, FL 33136-2107 | 2013-05-21 |
1477849446 | Gregory Michael Knoll | Surgery | 1611 Nw 12th Ave, Miami, FL 33136-1005 | 2011-06-28 |
Find all providers in MIAMI |
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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.