Provider Demographics
NPI:1295053593
Name:MEDINA SMESTER, JOSE GABRIEL (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:GABRIEL
Last Name:MEDINA SMESTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 BRICKELL AVE
Mailing Address - Street 2:STE 900
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-2979
Mailing Address - Country:US
Mailing Address - Phone:786-477-4292
Mailing Address - Fax:786-574-5584
Practice Address - Street 1:801 BRICKELL AVE
Practice Address - Street 2:SUITE 954
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-2951
Practice Address - Country:US
Practice Address - Phone:786-375-5098
Practice Address - Fax:786-375-5033
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-11
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME117746207RS0012X, 261QM1300X, 261QS1200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic