Nydialis La Santa Medina

Primary specialty

Speech-Language AssistantTaxonomy code 2355S0801X

License

4165 Issued in FL

Practice address

400 N. Lake Howard Dr
Winter Haven, FL 33881

Phone

(863) 268-2608

NPI assigned

Feb 3, 2021

Last updated

Feb 3, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Practice roles

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.

• First Step Therapy, LLC

  • Clinic/Center
  • Kissimmee, FL
  • NPI 1831420033
  NPD (past)

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

{
    "created_epoch": "1612310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1902497704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N LAKE HOWARD DR",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "33881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N. LAKE HOWARD DR",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "33881",
            "telephone_number": "863-268-2608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LA SANTA MEDINA",
        "first_name": "NYDIALIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-03",
        "last_updated": "2021-02-03",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "FL",
            "license": "4165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• KSC Cardiology PA
• David Kunberger
• Leah Anna Kuruvilla, FNP-C
• La Foi Home Care Services
• La Fortaleza Physical Therapy Center Inc
• Lab2Doors
• Amanda Labarge, DC
• Richard Lacalamito, DO
• Alina Ladha, MD
• Alma Pura Landrito Ladia, PT

• Speech-Language Assistant in Winter Haven, FL
• Providers in Winter Haven, FL by specialty
• Speech-Language Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; 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.