Provider Demographics
NPI:1952893638
Name:MEDINA CABAN, MARILYN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:
Last Name:MEDINA CABAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 CALLE CORAL
Mailing Address - Street 2:COND. LAGO PLAYA #2332
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949
Mailing Address - Country:US
Mailing Address - Phone:787-639-1953
Mailing Address - Fax:
Practice Address - Street 1:3000 CALLE CORAL
Practice Address - Street 2:COND. LAGO PLAYA #2332
Practice Address - City:TIA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-639-1953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-30
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program