Organization
ERIC D. MEDINA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC MEDINA MD (OWNER)
(561) 251-9099
Entity
Organization
Contact information
Practice address
18156 CLEAR BROOK CIR, BOCA RATON, FL 33498-1943
(561) 251-9099
Mailing address
18156 CLEAR BROOK CIR, BOCA RATON, FL 33498-1943
(561) 251-9099
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME135030
LICENSE
FL
Enumeration date
09/10/2019
Last updated
12/18/2019
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