Individual
MEDGINA ETIENNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1419 UNIVERSITY BLVD N, JACKSONVILLE, FL 32211-5249
(904) 745-0067
Mailing address
1419 UNIVERSITY BLVD N, JACKSONVILLE, FL 32211-5249
(904) 745-0067
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/25/2017
Last updated
01/25/2017
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