Individual
MR. MARLON MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1100 NW 95TH ST, MIAMI, FL 33150-2038
(305) 835-6000
Mailing address
3430 NW 97TH ST, MIAMI, FL 33147-2237
(786) 597-7426
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11005222
FL
Other
Enumeration date
11/21/2019
Last updated
11/28/2019
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