Provider Demographics
NPI:1013101021
Name:GARCIA MEDINA, AURELIO (MD)
Entity Type:Individual
Prefix:
First Name:AURELIO
Middle Name:
Last Name:GARCIA MEDINA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10067
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732-0067
Mailing Address - Country:US
Mailing Address - Phone:787-247-2427
Mailing Address - Fax:
Practice Address - Street 1:MANSION DEL LAGO CALLE 3 # 89
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00732-0067
Practice Address - Country:US
Practice Address - Phone:787-247-2427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-03
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16565207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine