Avis Marie Medina, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN17957 Issued in FL

Practice address

6230 Scott St
Unit 213
Punta Gorda, FL 33950-3940

Phone

(941) 457-5174

NPI assigned

Jun 13, 2007

Last updated

Jun 10, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244592000000",
    "number": "1740484823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6230 SCOTT ST",
            "address_2": "UNIT 213",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339503940",
            "telephone_number": "941-457-5174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6230 SCOTT ST",
            "address_2": "UNIT 213",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339503940",
            "telephone_number": "941-457-5174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "AVIS",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-13",
        "last_updated": "2009-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN17957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McDonnell Dermatology LLC
• Megan Rose McGill, PA-C
• Allison Kathryn McGrath
• Mederi of Collier County, Inc. (Mederi of Port Charlotte)
• Medical Risk Solutions (MHO-Charlotte County EHC-Punta Gorda)
• Melissa K Meister, RDN, LDN
• Joshua Mejias
• Amgad Malak Mekhail, RPH
• Farouk Meklat, PHARM.D.
• Amy Marie Mellor, M.D.

• General Practice Dentistry in Punta Gorda, FL
• Providers in Punta Gorda, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2009; 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.