AGE REJUVENATION MEDICAL, P.A. – NPI #1801603717
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Health Care Provider Taxonomy Code for Family Medicine

AGE REJUVENATION MEDICAL, P.A. is a provider located in WINTER PARK, FL. NPPES has assigned the NPI number 1801603717 to AGE REJUVENATION MEDICAL, P.A. on December 13, 2024. It is a Type-2 NPI, indicating this NPI number is associated with an organization. This provider is also associated with 2 additional names listed below. According to the NPI data, there are 5 additional location(s) assigned to this provider which are listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was last updated on Jan 20, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for AGE REJUVENATION MEDICAL, P.A. below.

NPI Profile for
AGE REJUVENATION MEDICAL, P.A.

NPI Number
1801603717
Enumeration Date

(more than a year ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
AGE REJUVENATION MEDICAL, P.A.
Other name(s)
All associated names:

Doing Business As (dba)
Age Rejuvenation
Primary location
125 N ORLANDO AVE STE 115
WINTER PARK, FL 32789-3605
Phone: (407) 565-5929 Fax:
5 Other location(s):
1155 Nikki View Dr
Brandon, FL 33511-4879
Phone: (813) 681-8624
220 N Howard Ave
Tampa, FL 33606-1529
Phone: (813) 254-6141
1940 Bruce B Downs Blvd
Wesley Chapel, FL 33544-9262
Phone: (813) 575-5577
12615 Race Track Rd
Westchase, FL 33626-1331
Phone: (813) 749-7550
5730 Hamlin Groves Trl Ste 176
Winter Garden, FL 34787-5792
Phone: (407) 564-1035
Mailing address
2409 N FALKENBURG RD
TAMPA, FL 33619-0915
Phone: Fax:
Organization Subpart
No
Authorized Official
YAZMYNE MIRANDA
COO
Phone: (954) 682-3015
Updated
Certification Date
Jan 20, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)
2083B0002X
- Preventive Medicine / Obesity Medicine
207QB0002X
- Family Medicine / Obesity Medicine
133VN1201X
- Dietitian, Registered / Nutrition, Obesity and Weight Management

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.