Individual
BENJAMIN LOUIS MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
405 W GRAND AVE, DAYTON, OH 45405-7538
(937) 723-3200
Mailing address
4045 BROOKDALE LN UNIT 7, DAYTON, OH 45440-4186
(207) 975-0076
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
152607
ME
Other
Enumeration date
12/11/2024
Last updated
12/11/2024
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