Organization
DR. MEDINA'S OPTICAL, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ARIEL MEDINA O.D. (PRESIDENT)
(305) 233-1330
Entity
Organization
Contact information
Practice address
8247 SW 124TH ST, PINECREST, FL 33156-5900
(305) 233-1330
(305) 233-1362
Mailing address
8247 SW 124TH ST, PINECREST, FL 33156-5900
(305) 233-1330
(305) 233-1362
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
OPC 4155
FL
332H00000X
Eyewear Supplier
OPC 4155
FL
Other
Enumeration date
09/04/2012
Last updated
04/12/2013
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