MEDICARE: DR. ANDRE MEDINA-SANCHEZ 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	207Q00000X	Family Medicine Physician	21646	PR
2	207QG0300X	Geriatric Medicine (Family Medicine) Physician	TRN45140	FL

General Provider Information

NPI Number	:	1073143780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDRE MEDINA-SANCHEZ MD

Provider Business Mailing Address
First Line	:	133 BENMORE DR STE 201
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-4111
Country	:	US
Telephone Number	:	407-646-7757
Fax Number	:

Provider Business Practice Location Address
First Line	:	133 BENMORE DR STE 201
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-4111
Country	:	US
Telephone Number	:	407-646-7757
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2020
Last Update Date	:	06/12/2026

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