| Doctor Name: | JOSE F MEDINA |
| NPI Number: | 1811029143 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 4983 |
| Business Practice Address: | 18 Calle Bou Barrio Pueblo Corozal, PR - 007832011 |
| Business Phone Number: | 7878594503 |
| Business Fax Number: | |
| Mailing Address: | Po Box 848, COROZAL |
| State: | PR |
| Postal Code: | 007830848 |
| Phone Number: | 7878594503 |
| Fax Number: | |
| NPI Enumeration Date: | 03/12/2007 |
| NPI Last Update Date: | 07/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 4983 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |