Provider Demographics
NPI:1114576675
Name:MEDINA, JANI (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:JANI
Middle Name:
Last Name:MEDINA
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4675 W 18TH CT APT 512
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2843
Mailing Address - Country:US
Mailing Address - Phone:786-267-1811
Mailing Address - Fax:
Practice Address - Street 1:1140 W 50TH ST STE 303
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3411
Practice Address - Country:US
Practice Address - Phone:305-231-3371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-08
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist