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1154696011
LISSETTE M MEDINA
MIAMI, FL
NPI
1154696011
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: FL PA9105170)
Enumeration Date
2012-03-12
Last Update Date
2012-03-12
Business Address
Ms. LISSETTE M MEDINA PA-C
3100 SW 62ND AVE
MIAMI, FL 33155-3009
Phone number: 305-662-8366
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Mailing Address
Ms. LISSETTE M MEDINA PA-C
3100 SW 62ND AVE
MIAMI, FL 33155-3009
Phone number: 305-662-8366
Copy
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