Teodoro Medina, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ACN 793 Issued in FL

Practice address

1729 David Walker Dr
Tavares, FL 32778-5745

Phone

(352) 508-4455

NPI assigned

Jan 30, 2007

Last updated

Jul 9, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Teodoro Medina Montano Other name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Practice

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Island Doctors Intrastate LLC

  • Primary Care Clinic/Center
  • St Augustine, FL
  • NPI 1568083889
  Medicare reassignment NPD
• Roy H Hinman MD PA

  dba Island Doctors

  • Family Medicine Physician
  • St Augustine, FL
  • NPI 1649383845
  Medicare reassignment NPD
• Florida Medical Associates LLC

  dba VIPcare

  • Primary Care Clinic/Center
  • Lady Lake, FL
  • NPI 1336153709
  NPD
• Michael G. Degnan, LLC

  dba Degnan Family Medicine

  • Family Medicine Physician
  • Davenport, FL
  • NPI 1730432345
  NPD
• Lina L Feaster PA

  • Primary Care Clinic/Center
  • St Augustine, FL
  • NPI 1922205251
  NPD (past)
• Medical Home Alliance LLC

  dba IMA Winter Haven Dispensary

  • Non-Pharmacy Dispensing Site
  • Winter Haven, FL
  • NPI 1033648233
  NPD (past)
• Clinica Estabilizadora de Salud Mental de Aguadilla Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Aguadilla, PR
  • NPI 1922281740
  NPD (past)
• Ponce Medical School Foundation Inc

  • Multi-Specialty Clinic/Center
  • Ponce, PR
  • NPI 1043208804
  NPD (past)

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1093852113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S HARBOUR ISLAND BLVD STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336025925",
            "telephone_number": "727-322-3439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1729 DAVID WALKER DR",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785745",
            "telephone_number": "352-508-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "TEODORO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN 793",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "14489",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BLUE",
            "identifier": "TW49T",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TEODORO",
            "last_name": "MONTANO",
            "middle_name": "MEDINA",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Grant Barry McGee, CRNA
• Aleen Joy McGowan
• Colleen Joy McIntyre, RN FIRST ASSISTANT
• Medical Cranial Hair Prosthetics (Prestige Hair Loss Solutions LLC)
• Medical Imaging Professionals PA
• Mending Minds LLC
• April Smith Mendoza, M.D.
• Ariella Mendoza
• Claudia F Mercedes
• Odline Mercius

• General Practice Physician in Tavares, FL
• Providers in Tavares, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.