MEDICARE: BERNARDO 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	207L00000X	Anesthesiology Physician	047757	CT
2	207L00000X	Anesthesiology Physician	239762	MA
3	207L00000X	Anesthesiology Physician	ME154919	FL

General Provider Information

NPI Number	:	1669685335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BERNARDO MEDINA MD

Provider Business Mailing Address
First Line	:	2995 DREW ST FL 2
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33759-3012
Country	:	US
Telephone Number	:	727-532-0002
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 AVENUE F NE
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33881-4131
Country	:	US
Telephone Number	:	727-532-0002
Fax Number	:

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

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	06/17/2026

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Directions to “ BERNARDO MEDINA MD” Practice Location

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