| Doctor Name: | GUSTAVO MEDINA |
| NPI Number: | 1932134020 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | ME92091 |
| Business Practice Address: | 270 Tamiami Trl N Naples, FL - 341025832 |
| Business Phone Number: | 2392610926 |
| Business Fax Number: | 2392610927 |
| Mailing Address: | Po Box 2495, NAPLES |
| State: | FL |
| Postal Code: | 341062495 |
| Phone Number: | 2392610926 |
| Fax Number: | 2392610927 |
| NPI Enumeration Date: | 07/11/2006 |
| NPI Last Update Date: | 07/20/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204C00000X |
| License Number: | ME92091 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine, Sports Medicine |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |