Carlos Medina MD PA

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

ME106831 Issued in FL

Legal business name

CARLOS MEDINA MD PA

Practice address

21110 Biscayne Blvd Ste 201
Aventura, FL 33180-1251

Phone

(786) 817-7808

Fax

(786) 551-2299

NPI assigned

Jan 7, 2016

Organization subpart

No

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

Authorized official

Name

Carlos Medina, M.D.NPI 1487895124

Title

Owner

Phone

(786) 817-7808

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Networks

• HealthSun Health Plans Network

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Carlos Reydell Medina, MD

  • Plastic Surgery Physician
  • Aventura, FL
  • NPI 1487895124
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1452124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728950400000",
    "number": "1700242617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 WATERSIDE LN",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330195005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21110 BISCAYNE BLVD STE 201",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801251",
            "telephone_number": "786-817-7808",
            "fax_number": "786-551-2299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10095 N Kendall Dr Ste 103",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331761797",
            "country_code": "US",
            "telephone_number": "786-817-7808",
            "fax_number": "786-551-2299",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11760 SW 40th St Ste 606",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331758105",
            "country_code": "US",
            "telephone_number": "786-817-7808",
            "fax_number": "786-551-2299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CARLOS MEDINA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-07",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-817-7808",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "ME106831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME106831",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nigel Quinton Carey-Kochan, DC
• Caring for the Caregiver, Inc.
• Hernan Carlisky, BA
• Carlos Cohen, MD PA
• Carlos E Coelho M D P a
• Shanee Carmel
• David Carmi
• Joseph Caroccio, DPT
• Carrazana Chiropractic, Inc
• Agostina Carrion

• Plastic and Reconstructive Surgery Physician in Aventura, FL
• Providers in Aventura, FL by specialty
• Plastic and Reconstructive Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.