Individual provider Active NPI

Alex Denis-Medina, ARNP

  • Adult Health Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1215354774
Registry record updated Feb 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
9312332 Issued in FL
Practice address
9009 Corporate Lake Dr
Tampa, FL 33634-2367
Phone
(941) 773-9781
NPI assigned
Mar 23, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 9312332 FL Primary

Addresses

Primary practice location

9009 Corporate Lake Dr
Tampa, FL 33634-2367

Mailing address

9009 Corporate Lake Dr
Tampa, FL 33634-2367
Phone (941) 773-9781

Other identifiers 1

IdentifierTypeStateIssuer
9312332OtherFLARNP LICENSE

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
I20140618000572 FL Order and Referring Only - Nurse Practitioner 1254555048

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9312332FLMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1395532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486684800000",
    "number": "1215354774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9009 CORPORATE LAKE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336342367",
            "telephone_number": "941-773-9781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9009 CORPORATE LAKE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336342367",
            "telephone_number": "941-773-9781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENIS-MEDINA",
        "first_name": "ALEX",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-23",
        "last_updated": "2017-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "9312332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARNP LICENSE",
            "identifier": "9312332",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.