Individual
NIDIA MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1431 NW 114TH AVE, PEMBROKE PINES, FL 33026-2522
(954) 609-4180
Mailing address
1431 NW 114TH AVE, PEMBROKE PINES, FL 33026-2522
(954) 609-4180
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
01/03/2017
Last updated
01/03/2017
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