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1497744874
IVAN MEDINA
MIAMI, FL
NPI
1497744874
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: FL 15106)
Enumeration Date
2005-10-18
Last Update Date
2007-07-08
Business Address
Mr. IVAN MEDINA
15043 S DIXIE HWY
MIAMI, FL 33176-7930
Phone number: 305-238-2474
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Mailing Address
Mr. IVAN MEDINA
18084 SW 152ND PL
MIAMI, FL 33187-7753
Phone number: 305-608-6887
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