Individual provider Active NPI

Mirnalis Martinez Vega, D.O

  • Family Medicine Physician
  • Palmetto, FL
National Provider Identifier
1043501000
Registry record updated Oct 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS12720 Issued in FL
Practice address
1003 17TH St W
Palmetto, FL 34221-3021
Phone
(941) 722-7785
Fax
(941) 729-5267
NPI assigned
Apr 26, 2011
Last updated
Oct 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS12720 FL Primary

Addresses

Primary practice location

1003 17TH St W
Palmetto, FL 34221-3021

Mailing address

1003 17TH St W
Palmetto, FL 34221-3021
Phone (941) 722-7785

Other names 1

  • Dr. Mirna Lis Martinez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140927000307 FL Practitioner - Family Practice 1850511775 Reassigns benefits to 2 organizations
I20230901001623 GA Practitioner - Family Practice 1850511775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Center LLPGroup PAC ID 9133032774, 12 clinicians

Practice addresses (Care Compare)

908 Hillcrest Pkwy
Dublin, GA 31021-4206
Phone 4782727411203

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
96939GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Criticare Clinics Inc CurrentSince Apr 30, 2019 Accepting new patients
Medical Center, LLP CurrentSince Jan 20, 2024 Accepting new patients
Jencare Neighborhood Medical Center South Dekalb, LLC Family Medicine CurrentSince Sep 5, 2023 Accepting new patients
Ian Family Medicine Inc Past Accepting new patients
Jencare Neighborhood Medical Center West End, LLC PastSince Aug 4, 2014 Accepting new patients

Locations

4741 S University Dr
Davie, FL 33328
Phone (954) 837-1050

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

14701 NW 77th Ave
Miami Lakes, FL 33014
Phone (305) 669-2833

15885 Pines Blvd
Pembroke Pines, FL 33027
Phone (954) 837-1300

2124 Candler Rd
Decatur, GA 30032
Phone (404) 836-0272

908 Hillcrest Pkwy
Dublin, GA 31021
Phone (478) 272-7411

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BFGHDD/Endpoint/BFGHDD
  • Direct secure messaging: medicalcenter@1221.direct.myezyaccess.com
  • Direct secure messaging: mirna.vega@dublinmc.eclinicaldirectplus.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1303776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792022400000",
    "number": "1043501000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 17TH ST W",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342213021",
            "telephone_number": "941-722-7785",
            "fax_number": "941-729-5267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 17TH ST W",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342213021",
            "telephone_number": "941-722-7785",
            "fax_number": "941-729-5267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGA",
        "first_name": "MIRNALIS",
        "middle_name": "MARTINEZ",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-26",
        "last_updated": "2026-10-15",
        "certification_date": "2026-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS12720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRNA",
            "last_name": "MARTINEZ",
            "middle_name": "LIS",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Palmetto, FL

Sources for this page

Verify at the official NPI Registry.