| Doctor Name: | CHRISTINE MEDINA |
| NPI Number: | 1003272089 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | SI 2569 |
| Business Practice Address: | 17941 Nw 77th Ct Hialeah, FL - 330152801 |
| Business Phone Number: | 3055875956 |
| Business Fax Number: | |
| Mailing Address: | 17941 Nw 77th Ct, HIALEAH |
| State: | FL |
| Postal Code: | 330152801 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 01/06/2016 |
| NPI Last Update Date: | 01/06/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2355S0801X |
| License Number: | SI 2569 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Specialist/Technologist |
| Taxonomy Specialization: | Speech-Language Assistant |
| Taxonomy Definition: | |