Individual
DR. CARLOS A MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1611 NW 12TH AVE, M851, MIAMI, FL 33101-6960
(305) 243-4029
(305) 243-8470
Mailing address
1611 NW 12TH AVE, BOX 016960 M851, MIAMI, FL 33101-6960
(305) 243-4029
(305) 243-8470
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
ME60360
FL
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
ME60360
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3732894-00
—
FL
Enumeration date
07/27/2006
Last updated
09/29/2021
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