Individual
JOSE GERMAN MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
10881 NW 75TH ST, MEDLEY, FL 33178-2206
(786) 477-1159
Mailing address
10881 NW 75TH ST, MEDLEY, FL 33178-2206
(786) 477-1159
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
16-738
FL
Other
Enumeration date
11/13/2018
Last updated
11/13/2018
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