Individual
MR. ALFRED MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
4691 S UNIVERSITY DR, DAVIE, FL 33328-3817
(954) 652-9804
Mailing address
4984 SW 158TH WAY, MIRAMAR, FL 33027-5607
(954) 652-9804
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
46042
FL
Other
Enumeration date
06/30/2009
Last updated
06/30/2009
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