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Organization
YOUR KISSIMMEE DENTIST PA
Active
Organization
YOUR KISSIMMEE DENTIST PA
Active
Other names
Columbia Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS MEDINA DMD (DENTIST)
(386) 717-5458
Entity
Organization
Contact information
Practice address
1135 W COLUMBIA AVE, KISSIMMEE, FL 34741-3202
(407) 933-4343
(407) 944-1434
Mailing address
13151 PALOMA DR, ORLANDO, FL 32837-8723
(808) 407-8085
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
08/27/2024
Last updated
08/27/2024
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