Annette Medina, CST

Primary specialty

Surgical TechnologistTaxonomy code 246ZS0410X

Practice address

4220 Lugano CT
Kissimmee, FL 34746-3434

Phone

(321) 442-2454

Fax

(407) 386-3006

NPI assigned

Oct 23, 2024

Last updated

Oct 23, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Superior Surgical PA's of FL,LLC

  • Surgical Assistant
  • Kissimmee, FL
  • NPI 1487250213
  NPD
• Superior Surgical Assisting, LLC

  • Surgical Physician Assistant
  • Kissimmee, FL
  • NPI 1164964516
  NPD (past)

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

{
    "created_epoch": "1729641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1508687336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 LUGANO CT",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347463434",
            "telephone_number": "321-442-2454",
            "fax_number": "407-386-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 LUGANO CT",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347463434",
            "telephone_number": "321-442-2454",
            "fax_number": "407-386-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "ANNETTE",
        "credential": "CST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-23",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "156F00000X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Medina Perez, MD
• Laisy Medina Rodriguez
• Eduardo Jose Medina Torres
• Nelson Medina Villanueva
• Medina-Meds Pharmacy, LLC
• Betzaida Medina
• Dryssi Nicolle Medina, F02241104
• Santa Medina
• Tony Alejandro Medina Sr.
• Medisound Inc

• Surgical Technologist in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Surgical Technologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.