Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Age Rejuvenation Medical, PA

Organization Obesity and Weight Management Nutrition Registered Dietitian · NPI 1801603717

Age Rejuvenation Medical, PA is an Obesity and Weight Management Nutrition Registered Dietitian in Winter Park, Florida. Works from 6 locations. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
4
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

125 N Orlando Ave Ste 115
Winter Park, FL 32789-3605
Phone: (407) 565-5929
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (5)

  • 1155 Nikki View Dr, Brandon, FL 33511-4879 — (813) 681-8624
  • 220 N Howard Ave, Tampa, FL 33606-1529 — (813) 254-6141
  • 1940 Bruce B Downs Blvd, Wesley Chapel, FL 33544-9262 — (813) 575-5577
  • 12615 Race Track Rd, Westchase, FL 33626-1331 — (813) 749-7550
  • 5730 Hamlin Groves Trl Ste 176, Winter Garden, FL 34787-5792 — (407) 564-1035

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Obesity and Weight Management Nutrition Registered Dietitian Taxonomy 133VN1201X
Obesity Medicine (Family Medicine) Physician Taxonomy 207QB0002X
Obesity Medicine (Preventive Medicine) Physician Taxonomy 2083B0002X

Record details

NPI number1801603717
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Yazmyne Miranda — Coo · (954) 682-3015
Other names Age Rejuvenation
NPI enumeratedDecember 13, 2024
Last updated in NPPESJanuary 20, 2025
Certification dateJanuary 20, 2025
Mailing address2409 N Falkenburg Rd, Tampa, FL 33619-0915

Other providers in Winter Park