MR. ANDRES MEDINA JR. (NPI# 1124388038) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124388038 |
| Entity Type | Individual |
| Full Name | MR. ANDRES MEDINA JR. |
| Credential | MA |
| Practice Address |
5707 N 22nd St Tampa FL 33610-4350 |
| Practice Telephone | 8132398448 |
| Practice Fax Number | 8132398513 |
| Mailing Telephone | 8132398448 |
| Mailing Fax Number | 8132398513 |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2015-05-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952871089 | Andres Medina | Student in an Organized Health Care Education/Training Program | 388 Zona Ind Reparada 2, Ponce, PR 00716-2347 | 2018-12-02 |
| 1861547978 | Andres Medina | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1324 Lakeland Hills Blvd, Lakeland, FL 33805-4543 | 2007-01-25 |
| Street Address |
5707 N 22ND ST |
| City | TAMPA |
| State | FL |
| Zip Code | 33610-4350 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629032073 | Stephanie Lockett | Psychiatry & Neurology | 5707 N 22nd St, Tampa, FL 33610-4350 | 2006-04-13 |
| 1861093759 | Alma Escalona | Registered Nurse | 5707 N 22nd St, Tampa, FL 33610-4350 | 2020-11-05 |
| 1003414863 | Beatriz Alvarez | Social Worker | 5707 N 22nd St, Tampa, FL 33610-4350 | 2020-10-14 |
| 1891393583 | Ada Rodriguez | Social Worker | 5707 N 22nd St, Tampa, FL 33610-4350 | 2020-10-14 |
| 1225643539 | Daris Nichole Rodriguez Zurinaga | Social Worker | 5707 N 22nd St, Tampa, FL 33610-4350 | 2020-09-14 |
| 1861014029 | Marcia Montel Nicholls | Licensed Practical Nurse | 5707 N 22nd St, Tampa, FL 33610-4350 | 2020-05-11 |
| 1376170167 | Erin E Evans | Counselor | 5707 N 22nd St, Tampa, FL 33610-4350 | 2020-03-24 |
| 1003440017 | Margaret Alejandro Rivera | Community Health Worker | 5707 N 22nd St, Tampa, FL 33610-4350 | 2020-02-28 |
| 1003449190 | Rossmery Villavicencio | Social Worker | 5707 N 22nd St, Tampa, FL 33610-4350 | 2020-02-17 |
| 1932739133 | Jennifer Lizaire | Counselor | 5707 N 22nd St, Tampa, FL 33610-4350 | 2020-01-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184273161 | Mayra Iris Pesante Lopez | Behavior Technician | 10150 Highlands Manor Drive Suite 200, Tampa, FL 33610 | 2019-09-11 |
| 1902464381 | Ruth Hosen Milfort | Case Manager/Care Coordinator | 5707 N. 22nd Street, Tampa, FL 33610 | 2019-05-31 |
| 1265914626 | Universal Transportation Management Inc | Non-emergency Medical Transport (VAN) | 4108 N 22nd Street, Tampa, FL 33610 | 2018-09-02 |
| 1346759115 | Speedway Plus 2 Car Care Center LLCc | Residential Treatment Facility, Physical Disabilities | 8007 Glenoak Rd., Tampa, FL 33610 | 2017-09-25 |
| 1245757707 | Duy Dang | Behavioral Analyst | 4402 Claymore Dr Unit 203, Tampa, FL 33610 | 2017-08-25 |
| 1144745043 | Jonequa Baker | Home Health Aide | 709 North Castle Court, Tampa, FL 33610 | 2017-08-11 |
| 1619401338 | Dedicated Senior Medical Center East Tampa, LLC. | Non-Pharmacy Dispensing Site | 3128 East Hillsborough Avenue, Dedicated Senior Medical Center East Tampa, LLC., Tampa, FL 33610 | 2017-04-19 |
| 1669917423 | Olivia Anderson | Counselor | 10150 Highland Manor Dr Ste 200#108, Tampa, FL 33610 | 2017-01-03 |
| 1952779050 | Tampa Family Health Centers, Inc | Clinic/Center | 3100 E. Fletcher Avenue, Tampa, FL 33610 | 2015-09-04 |
| 1215303821 | Morissa Kidd | Technician, Other | 8062 Deerwood Circle, Tampa, FL 33610 | 2015-08-18 |
| Find all providers in zip 33610 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316546146 | Rebecca M Slack | Counselor | 4422 E Columbus Dr Fl 33605, Tampa, FL 33605-3233 | 2020-10-22 |
| 1003415852 | Betsy Rose Rodriguez | Counselor | 1101 E Cumberland Ave # 201h-132, Tampa, FL 33602-4231 | 2020-10-22 |
| 1124626155 | Laverne Brown | Counselor | 10964 Brightside Dr, Tampa, FL 33624-7007 | 2020-10-12 |
| 1639786064 | Brittany Richardson Smiley | Counselor | 1610 E Osborne Ave, Tampa, FL 33610-6045 | 2020-09-29 |
| 1356957492 | Latoya K Claxton | Counselor | 17106 Carrington Park Dr Apt 601, Tampa, FL 33647-2627 | 2020-09-22 |
| 1679188718 | Jessica Marie Graham | Counselor | 3038 W Bearss Ave, Tampa, FL 33618-1811 | 2020-09-15 |
| 1952915795 | Kathy Thompson | Counselor | 4115 W Spruce St Ste 205, Tampa, FL 33607-2485 | 2020-08-31 |
| 1467066233 | Samantha Tubbs-crews, Lmhc | Counselor | 1211 N West Shore Blvd Ste 100, Tampa, FL 33607-4601 | 2020-08-31 |
| 1699388744 | R.e.s.e.t. Counseling Services LLC | Counselor | 1806 E Hanna Ave, Tampa, FL 33610-3543 | 2020-08-28 |
| 1700401056 | Jamie Tyus | Counselor | 3825 Henderson Blvd Ste 404, Tampa, FL 33629-5012 | 2020-06-12 |
| Find all providers in TAMPA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.