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1649259540
OTTO R MEDINILLA
FORT MYERS, FL
NPI
1649259540
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: DE C50000198)
Enumeration Date
2006-01-10
Last Update Date
2020-12-01
Business Address
Mr. OTTO R MEDINILLA PAC
11300 LINDBERGH BLVD STE 115
FORT MYERS, FL 33913-8827
Phone number: 239-245-8600
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Mailing Address
Mr. OTTO R MEDINILLA PAC
PO BOX 3048
WILMINGTON, DE 19804
Phone number: 302-224-5678
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