Active NPI
Melissa Yolanda Mejia Disla, MD
- Internal Medicine Physician
- Orlando, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME116099
- Practice address
- 690 S Goldenrod Rd
Orlando, FL 32822-8108 - Phone
- (407) 792-1144
- Fax
- (407) 232-9807
- NPI assigned
- Jun 22, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | ME116099 | FL | |
| Internal Medicine Physician | 207R00000X | ME116099 | FL | Primary |
Addresses
Primary practice location
690 S Goldenrod Rd
Orlando, FL 32822-8108
Mailing address
690 S Goldenrod Rd
Orlando, FL 32822-8108
Phone (407) 792-1144
Other practice location 1
10250 SE 167th Place Rd
Suite 5-1
Summerfield, FL 34491-8686
Phone (352) 307-9925
Other practice location 2
10250 SE 167th Place Rd
Suite 5-1
Summerfield, FL 34491-8686
Phone (352) 307-9925
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 014155200 | Medicaid | FL |
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dedicated Senior Medical Center of Florida, LLC | Current | Accepting new patients | |
| Dedicated Senior Medical Center of Florida, LLC | Current | Accepting new patients | |
| Manoogian Orthopedic Center, P.a. | Past | Accepting new patients | |
| Broward Institute of Neuro Science L L C | Past | Accepting new patients |
Locations
4715 S Florida Ave
Lakeland, FL 33813
Phone (863) 209-7003
1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760
690 S Goldenrod Rd
Orlando, FL 32822
Phone (407) 628-6117
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Organizations & group practices 4
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621900800000",
"number": "1194952754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "690 S GOLDENROD RD",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328228108",
"telephone_number": "407-792-1144",
"fax_number": "407-232-9807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "690 S GOLDENROD RD",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328228108",
"telephone_number": "407-792-1144",
"fax_number": "407-232-9807"
}
],
"practiceLocations": [
{
"address_1": "10250 SE 167th Place Rd",
"address_2": "Suite 5-1",
"address_purpose": "LOCATION",
"city": "Summerfield",
"state": "FL",
"postal_code": "344918686",
"country_code": "US",
"telephone_number": "352-307-9925",
"fax_number": "352-304-8442",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "10250 SE 167th Place Rd",
"address_2": "Suite 5-1",
"address_purpose": "LOCATION",
"city": "Summerfield",
"state": "FL",
"postal_code": "344918686",
"country_code": "US",
"telephone_number": "352-307-9925",
"fax_number": "352-304-8442",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MEJIA DISLA",
"first_name": "MELISSA",
"middle_name": "YOLANDA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-22",
"last_updated": "2021-05-25",
"certification_date": "2021-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "FL",
"license": "ME116099",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME116099",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "014155200",
"state": "FL"
}
],
"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 May 25, 2021; 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.