Individual provider Active NPI

Bryan Josue Merino

  • Physician Assistant
  • Kissimmee, FL
National Provider Identifier
1194694281
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9120978 Issued in FL
Practice address
812 W Oak St
Kissimmee, FL 34741-6625
Phone
(407) 201-6838
Fax
(407) 201-3739
NPI assigned
Nov 5, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9120978 FL Primary

Addresses

Primary practice location

812 W Oak St
Kissimmee, FL 34741-6625

Mailing address

PO Box 782009
Orlando, FL 32878-2009

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251216001156 FL Practitioner - Physician Assistant 4385138437 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment
Group practices
Gastroenterology Institute of Orlando LLCGroup PAC ID 1355619586, 6 clinicians

Practice addresses (Care Compare)

1111 S Semoran Blvd
Suite a
Orlando, FL 32807-1480
Phone (407) 201-3686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9120978FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular Institute of Orlando, PLLC CurrentSince Nov 15, 2025 Accepting new patients
Gastroenterology Institute of Orlando LLC CurrentSince Nov 15, 2025 Accepting new patients

Locations

812 W Oak St
Kissimmee, FL 34741
Phone (407) 201-3686

1111 S Semoran Blvd
Ste A
Orlando, FL 32807
Phone (321) 695-3200

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1762300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1194694281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 782009",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328782009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 W OAK ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347416625",
            "telephone_number": "407-201-6838",
            "fax_number": "407-201-3739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERINO",
        "first_name": "BRYAN",
        "middle_name": "JOSUE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-05",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9120978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.