Organization
CARLOS MEDINA MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS MEDINA M.D. (OWNER)
(786) 817-7808
Entity
Organization
Contact information
Practice address
21110 BISCAYNE BLVD STE 201, AVENTURA, FL 33180-1251
(786) 817-7808
(786) 551-2299
Mailing address
1101 WATERSIDE LN, HOLLYWOOD, FL 33019-5005
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
ME106831
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME106831
MEDICAL LICENSE
FL
Enumeration date
01/07/2016
Last updated
10/15/2024
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