Provider Demographics
NPI:1326746553
Name:MEDINA, FIORELA CAROLINA
Entity Type:Individual
Prefix:
First Name:FIORELA
Middle Name:CAROLINA
Last Name:MEDINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2930 MAGUIRE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-4750
Mailing Address - Country:US
Mailing Address - Phone:407-602-5010
Mailing Address - Fax:
Practice Address - Street 1:2930 MAGUIRE RD STE 200
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-4750
Practice Address - Country:US
Practice Address - Phone:407-602-5010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician