MEDICARE: SIXTO R MEDINA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1780536326
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIXTO R MEDINA MD

Provider Business Mailing Address
First Line	:	2211 LYELL AVE STE 111
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14606-5743
Country	:	US
Telephone Number	:	585-429-6550
Fax Number	:	585-429-7298

Provider Business Practice Location Address
First Line	:	2211 LYELL AVE STE 111
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14606-5743
Country	:	US
Telephone Number	:	585-429-6550
Fax Number	:	585-429-7298

Authorized Official
Title or Position	:	OWNER
Name	:	SIXTO R MEDINA
Credential	:	MD
Telephone Number	:	585-429-6550

Provider Enumeration Date	:	02/13/2026
Last Update Date	:	02/13/2026

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Directions to “SIXTO R MEDINA MD ” Practice Location

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