Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | ME118141 | FL |
NPI | 1033456959 |
---|---|
Provider Name | Linette Cintron-Medina |
First Address | Melbourne, FL 32941-0654 |
Second Address | Melbourne, FL 32901-8301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2013 |
Last Update Date | 13/10/2020 |