Individual
MR. DAVID J MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
11 CALLE SAN ANTONIO, RIO GRANDE, PR 00745-3065
(787) 299-9292
Mailing address
PO BOX 1479, RIO GRANDE, PR 00745-1479
(787) 299-9292
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4017
PR
Other
Enumeration date
06/17/2011
Last updated
06/17/2011
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