Individual
MR. ANDRES MEDINA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
5707 N 22ND ST, TAMPA, FL 33610-4350
(813) 239-8448
(813) 239-8513
Mailing address
5707 N 22ND ST, TAMPA, FL 33610-4350
(813) 239-8448
(813) 239-8513
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/24/2012
Last updated
05/07/2015
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