Individual
MR. IVAN MAXIMIALLIANO MEDRANO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
1400 NW 12TH AVE STE 2, MIAMI, FL 33136-1003
(305) 689-7600
(305) 243-1353
Mailing address
1400 NW 12TH AVE STE 2, MIAMI, FL 33136-1003
(305) 689-7600
(305) 243-1353
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN11021122
FL
Other
Enumeration date
07/29/2022
Last updated
10/18/2023
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