Provider Demographics
NPI:1134363823
Name:MEDICINA MEDICAL, LLC
Entity type:Organization
Organization Name:MEDICINA MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SEMIDEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-551-0753
Mailing Address - Street 1:4640 HINCKLEY INDUSTRIAL PKWY
Mailing Address - Street 2:SUITE 17
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-6017
Mailing Address - Country:US
Mailing Address - Phone:216-551-0753
Mailing Address - Fax:866-347-4070
Practice Address - Street 1:4640 HINCKLEY INDUSTRIAL PKWY
Practice Address - Street 2:SUITE 17
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-6017
Practice Address - Country:US
Practice Address - Phone:216-551-0753
Practice Address - Fax:866-347-4070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-24
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHHMEL11370332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies