Organization Active NPI

R Rosario-Medina MD LLC

  • Family Medicine Physician
  • Orlando, FL
National Provider Identifier
1194850990
Registry record updated Oct 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME67356 Issued in FL
Legal business name
R ROSARIO-MEDINA MD LLC
Practice address
1417 N Semoran Blvd
Ste 106
Orlando, FL 32807-3555
Phone
(407) 382-9703
Fax
(321) 766-4566
NPI assigned
Feb 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2007

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

Authorized official

Name
Mr. Ralph Rosario-Medina, MDNPI 1326084674
Title
Doctor
Phone
(407) 382-9703

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X ME67356 FL Primary

Addresses

Primary practice location

1417 N Semoran Blvd
Ste 106
Orlando, FL 32807-3555

Mailing address

1417 N Semoran Blvd
Ste 106
Orlando, FL 32807-3555
Phone (407) 382-9703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070309000211 FL Part B Supplier - Clinic/Group Practice 1557464617 Receives reassigned benefits from 1 practitioner
Practice locations: Orlando, FL

National Provider Directory

National Provider Directory

Locations

4711 Curry Ford Rd
Ste A
Orlando, FL 32812
Phone (407) 281-8700

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193356800000",
    "number": "1194850990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 N SEMORAN BLVD",
            "address_2": "STE 106",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328073555",
            "telephone_number": "407-382-9703",
            "fax_number": "321-766-4566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 N SEMORAN BLVD",
            "address_2": "STE 106",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328073555",
            "telephone_number": "407-382-9703",
            "fax_number": "321-766-4566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R ROSARIO-MEDINA MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-10-26",
        "status": "A",
        "authorized_official_last_name": "ROSARIO-MEDINA",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "407-382-9703",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME67356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.