Miguel A Medina Rodriguez, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

12542 Issued in PR

Practice address

2575 N Courtenay Pkwy
Merritt Island, FL 32953-4126

Phone

(321) 454-7148

Fax

(321) 449-5015

NPI assigned

Nov 3, 2005

Last updated

Feb 11, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392076800000",
    "number": "1427049972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2575 N COURTENAY PKWY",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329534126",
            "telephone_number": "321-454-7148",
            "fax_number": "321-449-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 N COURTENAY PKWY",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329534126",
            "telephone_number": "321-454-7148",
            "fax_number": "321-449-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA RODRIGUEZ",
        "first_name": "MIGUEL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2014-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "12542",
            "primary": true
        },
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "PR",
            "license": "12542",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Melissa McLean, MA CCC-SLP
• Tasha Louise McLeroy, COTA/L
• Calandra McMillan
• Naomi McNeil
• Medfast Urgent Care Centers, LLC
• Helen Katherine Medlin, RN
• Mefl, LLC
• Martin Megregian, D.D.S.
• David R Melchione, MSPT
• Virginia Melhorn

• Family Medicine Physician in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; 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.