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Individual

IVAN J MEDINA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
CIUDAD JARDIN III, 197 CALLE FLAMBOYAN, TOA ALTA, PR 00953
(787) 506-8499
(787) 279-4652
Mailing address
CIUDAD JARDIN III, 197 CALLE FLAMBOYAN, TOA ALTA, PR 00953
(787) 506-8499
(787) 279-4652

Taxonomy

Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary

Other

Enumeration date
12/18/2019
Last updated
12/18/2019
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