Individual
KELLY MARIA MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2801 NE 213TH ST STE 1001, AVENTURA, FL 33180-1265
(305) 466-9111
(305) 466-9127
Mailing address
3450 SW 124TH AVE, MIRAMAR, FL 33027-2941
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9119158
FL
Other
Enumeration date
03/06/2023
Last updated
01/29/2025
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