Ivelisse Medina

Primary specialty

Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X

License

2200 Issued in FL

Legal business name

IVELISSE MEDINA

Practice address

2275 Fortune Rd
Kissimmee, FL 34744-4404

Phone

(407) 348-2060

NPI assigned

Jul 14, 2016

Organization subpart

No

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

Authorized official

Name

Ivelisse Medina, SLPA

Title

Owner

Phone

(787) 479-6479

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468454400000",
    "number": "1518310549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12087 JEWEL FISH LN",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277141",
            "telephone_number": "787-479-6479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 FORTUNE RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347444404",
            "telephone_number": "407-348-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVELISSE MEDINA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-14",
        "last_updated": "2016-07-14",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "IVELISSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-479-6479",
        "authorized_official_credential": "SLPA"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "FL",
            "license": "2200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Kayla Israel
• Sruthy Alin Issac
• Bassill Itani, DPT
• Khaled Itani
• Cristina Ashley Iturrey, MD
• Roger Thomas Ivey, DDS.
• Ivps of Kissimmee
• Machiko Izawa, LMT
• Josue Izquierdo Marin
• J & E McKinnie, Inc

• Hearing and Speech Clinic/Center in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Hearing and Speech Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; 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.