Organization
ALAN MEDINA, MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN MEDINA MD (PRESIDENT)
(917) 856-6519
Entity
Organization
Contact information
Practice address
19 NEW WATER OAK DR, PALM COAST, FL 32137-6958
(917) 856-6519
(386) 597-2948
Mailing address
19 NEW WATER OAK DR, PALM COAST, FL 32137-6958
(917) 856-6519
(386) 597-2948
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
170738
NY
Other
Enumeration date
10/19/2011
Last updated
08/14/2021
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