Active NPI
Jesse Noel Medina, M.D.
- Internal Medicine Physician
- Tampa, FL
National Provider Identifier
1538855366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- TRN38295
- Practice address
- 17 Davis Blvd Ste 308
Tampa, FL 33606-3438 - Phone
- (813) 974-2201
- NPI assigned
- Apr 14, 2023
- Reactivated
- Nov 28, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | TRN38295 | FL | Primary |
Addresses
Primary practice location
17 Davis Blvd Ste 308
Tampa, FL 33606-3438
Mailing address
17 Davis Blvd Ste 308
Tampa, FL 33606-3438
Phone (813) 974-2201
Other practice location 1
1611 NW 12 Avenue, Central 600-D
Miami, FL 33136
Phone (305) 585-5215
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TRN38295 | FL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780358400000",
"number": "1538855366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 DAVIS BLVD STE 308",
"city": "TAMPA",
"state": "FL",
"postal_code": "336063438",
"telephone_number": "813-974-2201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 DAVIS BLVD STE 308",
"city": "TAMPA",
"state": "FL",
"postal_code": "336063438",
"telephone_number": "813-974-2201"
}
],
"practiceLocations": [
{
"address_1": "1611 NW 12 Avenue, Central 600-D",
"address_purpose": "LOCATION",
"city": "Miami",
"state": "FL",
"postal_code": "33136",
"country_code": "US",
"telephone_number": "305-585-5215",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MEDINA",
"first_name": "JESSE",
"middle_name": "NOEL",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-04-14",
"last_updated": "2026-06-02",
"certification_date": "2026-06-02",
"deactivation_date": "2023-11-17",
"reactivation_date": "2023-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "TRN38295",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.