Individual
GENEVA EZEL MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6100 LAKE ELLENOR DR STE 261, ORLANDO, FL 32809-4638
(407) 968-7807
Mailing address
152 ROYAL PALM DR, KISSIMMEE, FL 34743-4071
(407) 765-1381
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SI6576
FL
Other
Enumeration date
09/04/2023
Last updated
09/04/2023
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