Individual
MERCEDES Y MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10650 W STATE ROAD 84 STE 206, DAVIE, FL 33324-4235
(954) 634-3636
(954) 634-3637
Mailing address
5309 NW 42ND AVE, FORT LAUDERDALE, FL 33319-2965
(954) 865-9954
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021627300
—
FL
Enumeration date
08/29/2017
Last updated
08/29/2017
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