# MEDLANDS PA INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134388606
- **Authorized official:** DR. YURI O ALVAREZ (PRESIDENT)
- **Authorized official phone:** (305) 283-7956

## Contact information

- **Practice address:** 15830 SW 252ND ST, HOMESTEAD, FL 33031-2018
- **Practice address phone:** (305) 283-7956
- **Mailing address:** 15830 SW 252ND ST, HOMESTEAD, FL 33031-2018
- **Mailing address phone:** (305) 283-7956

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 364SA2200X | Adult Health Clinical Nurse Specialist | — | NULL | Yes |
| 364SA2200X | Adult Health Clinical Nurse Specialist | — | — | Yes |

## Other

- **Enumeration date:** 06/09/2008
- **Last updated:** 02/01/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000187601 | — | FL |
| 01 | — | Y127N | BCBSFL | FL |