Individual
NYDIALIS LA SANTA MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 N. LAKE HOWARD DR, WINTER HAVEN, FL 33881
(863) 268-2608
Mailing address
400 N LAKE HOWARD DR, WINTER HAVEN, FL 33881
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
4165
FL
Other
Enumeration date
02/03/2021
Last updated
02/03/2021
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