Individual
ROBERTO E MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCP
Contact information
Practice address
4604 SANDALWOOD DR, LAS CRUCES, NM 88011-9627
(505) 522-2418
Mailing address
4604 SANDALWOOD DR, LAS CRUCES, NM 88011-9627
(505) 522-2418
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
PF0495
TX
Other
Enumeration date
12/18/2007
Last updated
12/18/2007
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