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Individual

DR. ANITA JANINE MEDINA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
13087 SW 197TH ST, MIAMI, FL 33177-4807
(305) 773-7411
Mailing address
13087 SW 197TH ST, MIAMI, FL 33177-4807
(305) 773-7411

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS11420
FL
208M00000X
Hospitalist Physician
OS11420
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OS11420
FLORIDA MEDICAL LICENSE
FL
Enumeration date
02/25/2009
Last updated
09/12/2011
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