Individual provider Active NPI

Meredith Tracey Renodo

  • Medical Physician Assistant
  • North Miami Beach, FL
National Provider Identifier
1356141774
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
002220-PA Issued in PR
Practice address
16855 NE 2ND Ave Ste 102
North Miami Beach, FL 33162-1744
Phone
(786) 914-8860
NPI assigned
Mar 14, 2025
Last updated
Mar 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 002220-PA PR Primary

Addresses

Primary practice location

16855 NE 2ND Ave Ste 102
North Miami Beach, FL 33162-1744

Mailing address

13499 Biscayne Blvd
North Miami, FL 33181-2043
Phone (786) 914-8860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
002220-PAPRMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1741910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1356141774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13499 BISCAYNE BLVD",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331812043",
            "telephone_number": "786-914-8860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16855 NE 2ND AVE STE 102",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331621744",
            "telephone_number": "786-914-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENODO",
        "first_name": "MEREDITH",
        "middle_name": "TRACEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-14",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PR",
            "license": "002220-PA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.