| Yesenia Medina DO PA | |
|
11373 Sw 211th St Miami FL 33189-2245 | |
| (305) 234-0009 | |
| (305) 234-8688 |
| Full Name | Yesenia Medina DO PA |
|---|---|
| Speciality | Family Medicine |
| Location | 11373 Sw 211th St, Miami, Florida |
| Authorized Official Name and Position | Yesenia Medina (DOCTOR) |
| Authorized Official Contact | 3052348688 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Yesenia Medina DO PA 2394 Nw 5th St Miami FL 33125-4416 Ph: (305) 234-0009 | Yesenia Medina DO PA 11373 Sw 211th St Miami FL 33189-2245 Ph: (305) 234-0009 |
| NPI Number | 1073818761 |
|---|---|
| Provider Enumeration Date | 01/11/2011 |
| Last Update Date | 01/11/2011 |
| Medicare PECOS PAC ID | 9830326115 |
|---|---|
| Medicare Enrollment ID | O20131211001714 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073818761 | NPI | - | NPPES |
| 1043462211 | Other | FL | INDIVIDUAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS10520 (Florida) | Primary |
| Provider Name | Yesenia Medina |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043462211 PECOS PAC ID: 9830326123 Enrollment ID: I20131211001825 |
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