Individual
JACKMARY MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
33 W 60TH ST FL 6, NEW YORK, NY 10023-7905
(212) 606-2300
Mailing address
200 AVENUE F NE, WINTER HAVEN, FL 33881-4131
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11046398
FL
Other
Enumeration date
04/15/2026
Last updated
05/05/2026
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