DR. ABDON J. MEDINA (NPI# 1598799181) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598799181 |
| Entity Type | Individual |
| Full Name | DR. ABDON J. MEDINA |
| Credential | M.D. |
| Practice Address |
4848 Coconut Creek Pkwy Suite 100 Coconut Creek FL 33063-3904 |
| Mailing Address |
2234 Colonial Blvd Attn: Payer Contracting & Relations Dept. Fort Myers FL 33907-1412 |
| Practice Telephone | 9543794848 |
| Practice Fax Number | 9546423636 |
| Mailing Telephone | 2399317342 |
| Mailing Fax Number | 2399317385 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2016-10-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | ME47189 | FL | Other Service Providers |
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
ME47189 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBS | 02161 | 01 |
| FL | AETNA | 5410745 | 01 |
| FL | WELLCARE | 474368 | 01 |
| FL | RR MEDICARE | P01584477 | 01 |
| FL | DIMENSION | 10063 | 01 |
| FL | OPTIMUM | P971366 | 01 |
| FL | AVMED | 209883 | 01 |
| FL | FREEDOM | P1035607 | 01 |
| Street Address |
4848 COCONUT CREEK PKWY SUITE 100 |
| City | COCONUT CREEK |
| State | FL |
| Zip Code | 33063-3904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861769218 | Ian Todd Johnson Md LLC | Neurological Surgery | 4848 Coconut Creek Pkwy, 200, Coconut Creek, FL 33063-3904 | 2011-11-29 |
| 1477587830 | Edward J. Kaplan | Radiology | 4848 Coconut Creek Pkwy, Suite 100, Coconut Creek, FL 33063-3904 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558978734 | Ashley Bayliss | Counselor | Legacy Healing Center Margate, 2960 N State Road 7 Ste 102, Margate, FL 33063 | 2020-09-30 |
| 1366051872 | Tasheen Fletcher | Social Worker | 4716 West Atlantic Blvd, Coconut Creek, FL 33063 | 2020-07-30 |
| 1437768116 | Care for You Medical Center, LLC | Clinic/Center | 5412 West Atlantic Blvd, Margate, FL 33063 | 2020-07-28 |
| 1073130621 | Freedom of Speech Therapy Center | Clinic/Center | 6344 Duval Drive, Margate, FL 33063 | 2020-06-30 |
| 1326683558 | Timekia Miller | Nurse Practitioner | 6343 Harbor Bnd, Margate, FL 33063 | 2019-11-12 |
| 1487138236 | Kavine Annita Taylor-dyke | Nurse Practitioner | 272 Nw 80th Terrace, Margate, FL 33063 | 2018-09-18 |
| 1750890513 | Breath of Life Medical Center Inc | Internal Medicine | 5090 Coconut Creek Pkwy, Margate, FL 33063 | 2017-09-25 |
| 1881116796 | Stephanie Lola Backer | Nurse Practitioner | 5825 Toscana Place, Apt 206, Margate, FL 33063 | 2017-07-12 |
| 1346761384 | Kayan Oconnor Robinson | Technician, Other | 300 Lakewood Circle, Unit C, Margate, FL 33063 | 2017-06-29 |
| 1245610138 | Shailee B Patel | Dermatology | 3275 N. State Road 7, Margate, FL 33063 | 2015-06-04 |
| Find all providers in zip 33063 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083790034 | Edward J Kaplan, Md, Pa | Radiology | 4848 Coconut Creek Pkway, Suite 100, Coconut Creek, FL 33063-3904 | 2006-10-31 |
| 1477587830 | Edward J. Kaplan | Radiology | 4848 Coconut Creek Pkwy, Suite 100, Coconut Creek, FL 33063-3904 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114539079 | Mydoctoreb LLC | Radiology | 17407 Lotino Pl, Lutz, FL 33548-4815 | 2020-08-20 |
| 1417516600 | Arthur J. Iglesias, M.d. P.a. | Radiology | 1100 N.w. 95th Street, Cancer Center, Miami, FL 33150 | 2019-06-11 |
| 1962970111 | William A Assad, M.d. | Radiology | 3202 Henderson Blvd Ste 204a, Tampa, FL 33609-3043 | 2018-11-06 |
| 1508361361 | Marian Ingram | Radiology | 350 Nw 84th Ave Ste 102, Plantation, FL 33324-1820 | 2018-03-26 |
| 1376051870 | Indian River Health Services Inc | Radiology | 3555 10th Ct Ste 101, Vero Beach, FL 32960-5013 | 2018-01-18 |
| 1417492497 | Flagler Hospital, Inc. | Radiology | 97 Health Park Blvd, Saint Augustine, FL 32086-5777 | 2016-12-29 |
| 1447614441 | Benjamin Spieler | Radiology | 1475 Nw 12th Ave # Sccc1500, Miami, FL 33136-1002 | 2016-04-06 |
| 1629461371 | Florida Oncology Tavares, LLC | Radiology | 2010 Nightingale Ln, Tavares, FL 32778-4361 | 2015-03-05 |
| 1285042036 | Gulf Region Radiation Oncology Centers | Radiology | 1545 Airport Blvd Ste 1000, Pensacola, FL 32504-8615 | 2014-07-24 |
| 1962812917 | Florida Oncology Partners LLC | Radiology | 1100 N.w. 95 Street, Cancer Center, Miami, FL 33150-2038 | 2014-04-29 |
| Find all providers with the same taxonomy | ||||
| City | COCONUT CREEK |
| Zip Code | 33063 |
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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.