Medina, Michelle

Medina, Michelle is an sole proprietor health care provider with primary practice located at 657 South Dr Ste 403 , Miami Springs FL 33166-5926. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as her primary health care specialty. Medina, Michelle can be contacted via phone (786) 860-5161.

Contact Information

Primary practice address
657 South Dr Ste 403 Miami Springs FL 33166-5926
Phone: (786) 860-5161
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X

Profile Details

NPI number 1255821708
LBN Legal business name Medina, Michelle
Credentials BCBA
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 10th, 2018
Last updated Jan 12th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255821708 NPPES
Florida MEDICAID 021768000

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