Provider Demographics
NPI:1124364633
Name:MEDIAL SOLUTIONS
Entity Type:Organization
Organization Name:MEDIAL SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMLET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-687-0512
Mailing Address - Street 1:19 BALD EAGLE DR STE C
Mailing Address - Street 2:
Mailing Address - City:MARCO ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:34145-3580
Mailing Address - Country:US
Mailing Address - Phone:239-687-0512
Mailing Address - Fax:239-394-7706
Practice Address - Street 1:19 BALD EAGLE DR STE C
Practice Address - Street 2:
Practice Address - City:MARCO ISLAND
Practice Address - State:FL
Practice Address - Zip Code:34145-3580
Practice Address - Country:US
Practice Address - Phone:239-687-0512
Practice Address - Fax:239-394-7706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty