Gwendolyn Diaz Medina, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

1571 Issued in FL

Practice address

833 E Oak St
Kissimmee, FL 34744-5838

Phone

(844) 665-4827

NPI assigned

Jul 5, 2022

Sex

Female

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

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gwendolyn.diaz@wwmp.eclinicaldirectplus.com

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.

• Guidewell Sanitas I, LLC

  dba Clinisanitas

  • Family Medicine Physician
  • Doral, FL
  • NPI 1396124046
  NPD

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1578296844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2262 CHATHAM PLACE DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328244766",
            "telephone_number": "407-267-8203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 E OAK ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347445838",
            "telephone_number": "844-665-4827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ MEDINA",
        "first_name": "GWENDOLYN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-05",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "023427",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "1571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liz Barbara Diaz Ferrer
• Aimee Diaz Fontanez
• Leidianais Diaz Gonzalez
• Lianais Diaz Gonzalez
• Arbelio Mauro Diaz Hernandez
• Dayana A Diaz Sanchez
• Mileydis Diaz Sanchez
• Yamileth Diaz Sanchez
• Norma Diaz Suarez
• Diaz TCM

• General Practice Physician in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; 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.