Individual
MR. MIGUEL MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ITDS
Contact information
Practice address
17615 FRANJO RD, VILLAGE OF PALMETTO BAY, FL 33157-5636
(786) 268-2611
Mailing address
17615 FRANJO RD, VILLAGE OF PALMETTO BAY, FL 33157-5636
(786) 268-2611
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
09/21/2006
Last updated
07/09/2007
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