| Miguel A Medina Md Pa | |
|
119 S Park Ave Titusville FL 32796-3377 | |
| (321) 264-8644 | |
| (321) 264-8933 |
| Full Name | Miguel A Medina Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 119 S Park Ave, Titusville, Florida |
| Authorized Official Name and Position | Miguel Angel Medina (PHYSICIAN) |
| Authorized Official Contact | 3212686111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Miguel A Medina Md Pa 119 S Park Ave Titusville FL 32796-3377 Ph: (321) 264-8644 | Miguel A Medina Md Pa 119 S Park Ave Titusville FL 32796-3377 Ph: (321) 264-8644 |
| NPI Number | 1053584011 |
|---|---|
| Provider Enumeration Date | 04/10/2008 |
| Last Update Date | 08/17/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053584011 | NPI | - | NPPES |
| ME97000 | Other | FL | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME0097000 (Florida) | Primary |
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