Individual
SAMUEL MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
C18 CALLE 5, ESTANCIAS DE SAN FERNANDO, CAROLINA, PR 00985-5215
(787) 438-4798
(787) 768-4977
Mailing address
C18 CALLE 5, ESTANCIAS DE SAN FERNANDO, CAROLINA, PR 00985-5215
(787) 438-4798
(787) 768-4977
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2199
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0720683
DRIVERS LICENCE
PR
Enumeration date
01/03/2007
Last updated
07/08/2007
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