Individual
IVELISSE MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
11993 KAJETAN LN, ORLANDO, FL 32827-7153
(407) 335-8578
Mailing address
11993 KAJETAN LN, ORLANDO, FL 32827-7153
(407) 335-8578
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SZ13229
FL
261QH0700X
Hearing and Speech Clinic/Center
Primary
SI2200
FL
Other
Enumeration date
09/15/2023
Last updated
03/12/2026
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