Organization
MARISEL MEDINA DPM PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARISEL MEDINA (PRESIDENT)
(786) 317-8037
Entity
Organization
Contact information
Practice address
11760 SW 40TH ST, STE H 451, MIAMI, FL 33175
(786) 317-8033
Mailing address
11930 N BAYSHORE DR, APT 310, N MIAMI, FL 33181
(786) 317-8033
(305) 891-7324
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
P03198
FL
Other
Enumeration date
09/09/2006
Last updated
09/25/2007
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