Organization
DR NELSON R MEDINA, MD C.S.P.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NELSON R MEDINA MORENO M.D. (MEDICO)
(787) 813-2385
Entity
Organization
Contact information
Practice address
EDIFICIO PORRATA PILA 2431 AVE. LAS AMERICAS, SUITE 101, PONCE, PR 00731
(787) 813-2385
(787) 984-1691
Mailing address
PO BOX 332228, PONCE, PR 00733-2228
(787) 813-2385
(787) 984-1691
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12324
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1770543514
NPI
PR
Enumeration date
02/26/2007
Last updated
08/22/2020
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