Individual
NELSON MEDINA CANCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1798 SW BRADWAY LN, PORT ST LUCIE, FL 34953-1621
(786) 930-0548
Mailing address
1798 SW BRADWAY LN, PORT ST LUCIE, FL 34953-1621
(786) 930-0548
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/17/2024
Last updated
04/19/2024
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