Vivian Del Carmen Medina, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11025782 Issued in FL

Practice address

14 Office Park Dr Ste 6
Palm Coast, FL 32137-3830

Phone

(407) 299-7333

NPI assigned

Apr 14, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: clinical@mfda.directbygreenway.com

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

• Mid-Florida Dermatology Associates P.a.

  • Dermatology Physician
  • Orlando, FL
  • NPI 1619018561
  Medicare reassignment NPD

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

{
    "created_epoch": "1681430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1043906753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3927 S TRAPANI DR",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320923496",
            "telephone_number": "904-521-0994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 OFFICE PARK DR STE 6",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321373830",
            "telephone_number": "407-299-7333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 Plantation Island Dr S Ste 403B",
            "address_purpose": "LOCATION",
            "city": "Saint Augustine",
            "state": "FL",
            "postal_code": "320803118",
            "country_code": "US",
            "telephone_number": "407-299-7333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "VIVIAN",
        "middle_name": "DEL CARMEN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-14",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11025782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Ann McMurray, ARNP
• Emily McRee, APRN
• Carolanne McWilliams, LDO
• MD Transformations LLC
• Alan Medina, M.D.
• Mediquick Urgent Care Centers Inc
• Mefl, LLC
• Anoosha Mehmood, MD
• Sarah Melendez, LCSW
• Mayeisi Melgarejo, RBT

• Family Nurse Practitioner in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.