Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Charles Kenji Miyamoto, PA-C

Individual provider Surgical Physician Assistant · NPI 1487153078

Charles Kenji Miyamoto, PA-C is a Physician Assistant in Orlando, Florida. Qualified in 2017, 9 years ago. Practices with Orlando Health Medical Group Inc, a 2,137-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
9
Licensed in
FL
In the registry since
2018
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1400 S Orange Ave
Orlando, FL 32806-2134
Phone: (321) 843-8010
Fax: (321) 843-6330
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4215 Edgewater Dr, Orlando, FL 32804-2206 — (973) 826-8291

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA9115276 (FL)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence PA9115276 (FL)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1487153078
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedFebruary 8, 2018
Last updated in NPPESJuly 8, 2024
Certification dateJuly 8, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Orlando Health Medical Group Inc — 2137 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations12 on file with Medicare

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