Active NPI
Fernando Medina, DR.
- Clinical Psychologist
- Bayamon, PR
National Provider Identifier
1669561718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 634
- Practice address
- Condominio Las Torres,
Suite 6E, Torre Sur
Bayamon, PR 00959 - Phone
- (787) 384-4013
- Fax
- (787) 785-3985
- NPI assigned
- Oct 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 634 | PR | Primary |
Addresses
Primary practice location
Condominio Las Torres,
Suite 6E, Torre Sur
Bayamon, PR 00959
Mailing address
CB-6, Eucalipto St., Riohondo III,
Bayamon, PR 00961
Phone (787) 384-4013
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 634 | PR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669561718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "CB-6, EUCALIPTO ST., RIOHONDO III,",
"city": "BAYAMON",
"state": "PR",
"postal_code": "00961",
"telephone_number": "787-384-4013",
"fax_number": "787-785-3985"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CONDOMINIO LAS TORRES,",
"address_2": "SUITE 6E, TORRE SUR",
"city": "BAYAMON",
"state": "PR",
"postal_code": "00959",
"telephone_number": "787-384-4013",
"fax_number": "787-785-3985"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "FERNANDO",
"credential": "DR.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "634",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bayamon, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.