Emilio Miguel Pena, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME150763 Issued in FL

Practice address

11100 Summer Ridge Lane
Fort Myers, FL 33908-3289

Phone

(239) 344-2307

Fax

(239) 267-6219

NPI assigned

Jun 17, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1529193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1386138030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 919771",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001",
            "telephone_number": "239-278-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 SUMMER RIDGE LANE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083289",
            "telephone_number": "239-344-2307",
            "fax_number": "239-267-6219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "EMILIO",
        "middle_name": "MIGUEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-17",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME150763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rafael Angel Pena Garcia, APRN, FNP-C
• Liz Pena Jordan
• Mariela Pena Napoles, RPH
• Yuliet Pena Rodriguez
• Marileydi Pena-Pineda
• Yamelly E Pena, MA
• Janislay Penalver
• Edgar Comson Penano, P.T.
• Carlo T Penaranda, P.T.
• Dexter Penaranda

• Pediatrics Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.

Verify at the official NPI Registry.