Provider Demographics
NPI:1932331022
Name:MEDINA, ALICIA CARIDAD (ARNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:CARIDAD
Last Name:MEDINA
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10040 SW 40TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-3946
Mailing Address - Country:US
Mailing Address - Phone:305-559-3605
Mailing Address - Fax:305-559-7287
Practice Address - Street 1:10040 SW 40TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-3946
Practice Address - Country:US
Practice Address - Phone:305-559-3605
Practice Address - Fax:305-559-7287
Is Sole Proprietor?:No
Enumeration Date:2009-08-22
Last Update Date:2009-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9244245363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily