| Vivian Del Carmen Medina, APRN | |
| 
					14 Office Park Dr Ste 6, Palm Coast, FL 32137-3830  | |
| (407) 299-7333 | |
| Not Available | 
| Full Name | Vivian Del Carmen Medina | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner - Family | 
| Location | 14 Office Park Dr Ste 6, Palm Coast, Florida | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1043906753 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 11025782 (Florida) | Primary | 
| Entity Name | Mid-florida Dermatology Associates Pa | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1619018561 PECOS PAC ID: 1254233786 Enrollment ID: O20051018000717  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Vivian Del Carmen Medina, APRN 3927 S Trapani Dr, Saint Augustine, FL 32092-3496 Ph: (904) 521-0994  | Vivian Del Carmen Medina, APRN 14 Office Park Dr Ste 6, Palm Coast, FL 32137-3830 Ph: (407) 299-7333  | 
Jennifer A Schroeder, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 61 Memorial Medical Pkwy Ste 2812, Palm Coast, FL 32164 Phone: 386-586-1860 Fax: 386-586-1861  | |
Jennifer Marie Agosto, ACNPC-AG Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 60 Piedmont Dr, Palm Coast, FL 32164 Phone: 305-588-0373  | |
Amanda Vera, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 61 Memorial Medical Pkwy Ste 2815, Palm Coast, FL 32164 Phone: 386-586-1810 Fax: 386-586-1811  | |
Traci Serrano, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 61 Memorial Medical Pkwy Ste 3816, Palm Coast, FL 32164 Phone: 386-586-1720  | |
Mrs. Venus M. Valliere, ARNP BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 20 Cypress Point Pkwy Ste A, Palm Coast, FL 32164 Phone: 386-586-7005 Fax: 844-867-3940  | |
Mrs. Suzanne Korum, ARNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 20 Cypress Point Pkwy Ste A, Palm Coast, FL 32164 Phone: 386-586-7005 Fax: 844-867-3940  |