Provider Demographics
NPI:1750170171
Name:MEDINA VALENTIN, ANNETTE
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:MEDINA VALENTIN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:ANNETTE
Other - Middle Name:
Other - Last Name:MEDINA VALENTIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ANNETTE MEDINA VALEN
Mailing Address - Street 1:HC 2 BOX 7815
Mailing Address - Street 2:
Mailing Address - City:BARCELONETA
Mailing Address - State:PR
Mailing Address - Zip Code:00617-9857
Mailing Address - Country:US
Mailing Address - Phone:787-399-4479
Mailing Address - Fax:
Practice Address - Street 1:PR-2 KM 11.7
Practice Address - Street 2:
Practice Address - City:BAYAMO
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-472-8282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program