Individual
MARY M. MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6856 SW 53RD ST, MIAMI, FL 33155-5716
(305) 666-5871
Mailing address
6856 SW 53RD ST, MIAMI, FL 33155-5716
(305) 666-5871
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL369
FL
Other
Enumeration date
08/21/2014
Last updated
08/21/2014
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