Antonio Enrique Gutierrez Mendiola, MD is a medicare enrolled "Family Medicine" provider in Pembroke Pines, Florida. His current practice location is
11460 Pines Blvd, Pembroke Pines, Florida. You can reach out to his office (for appointments etc.) via phone at
(954) 874-5526.
Antonio Enrique Gutierrez Mendiola is licensed to practice in Florida (license number ME168251) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1134742182.
Healthcare Provider's Profile
Full Name | Antonio Enrique Gutierrez Mendiola |
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Gender | Male |
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Speciality | Family Medicine |
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Location | 11460 Pines Blvd, Pembroke Pines, Florida |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1134742182
- Provider Enumeration Date: 05/26/2020
- Last Update Date: 07/02/2024
Medicare PECOS Information:
- PECOS PAC ID: 6002352739
- Enrollment ID: I20240718001330
Medical Identifiers
Medical identifiers for Antonio Enrique Gutierrez Mendiola such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1134742182 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1835P0018X | Pharmacist - Pharmacist Clinician (phc)/ Clinical Pharmacy Specialist | 36271R (Puerto Rico) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (Puerto Rico) | Secondary |
207Q00000X | Family Medicine | ME168251 (Florida) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Antonio Enrique Gutierrez Mendiola allows following entities to bill medicare on his behalf.
Entity Name | Conviva Medical Center Management, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1649324278 PECOS PAC ID: 4284717422 Enrollment ID: O20080212000415 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Antonio Enrique Gutierrez Mendiola is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Antonio Enrique Gutierrez Mendiola, MD 11460 Pines Blvd, Pembroke Pines, FL 33026-4128 Ph: (786) 925-4234 | Antonio Enrique Gutierrez Mendiola, MD 11460 Pines Blvd, Pembroke Pines, FL 33026-4128 Ph: (954) 874-5526 |
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