Individual
ALEXIS J MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
554 CHERRY RD, HAVERHILL, FL 33409-6253
(561) 494-5438
Mailing address
554 CHERRY RD, HAVERHILL, FL 33409-6253
(561) 494-5438
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/28/2021
Last updated
02/28/2021
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