Individual provider Active NPI

Jeannie Paola Medina Paez, MD

  • Pediatrics Physician
  • Ocoee, FL
National Provider Identifier
1073009056
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME147502 Issued in FL
Practice address
10125 W Colonial Dr Ste 205
Ocoee, FL 34761-4200
Phone
(407) 578-1241
Fax
(407) 578-1242
NPI assigned
Jul 2, 2018
Last updated
Mar 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME147502 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

10125 W Colonial Dr Ste 205
Ocoee, FL 34761-4200

Mailing address

10125 W Colonial Dr Ste 205
Ocoee, FL 34761-4200
Phone (407) 578-1241

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME147502FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saltzman, Tanis, Pittel, Levin and Jacobson, LLC Pediatrics CurrentSince Feb 2, 2025 Accepting new patients
Soma Medical Center, P. a #4 Pediatrics Past Accepting new patients
Saltzman, Tanis, Pittell, Levin and Jacobson Pediatrics PastSince Feb 2, 2025 Accepting new patients

Locations

3274 Greenwald Way N
Kissimmee, FL 34741

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AWCHU1

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1073009056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10125 W COLONIAL DR STE 205",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614200",
            "telephone_number": "407-578-1241",
            "fax_number": "407-578-1242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10125 W COLONIAL DR STE 205",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614200",
            "telephone_number": "407-578-1241",
            "fax_number": "407-578-1242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA PAEZ",
        "first_name": "JEANNIE",
        "middle_name": "PAOLA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-02",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME147502",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocoee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.