Provider Demographics
NPI:1225066012
Name:MEDINA, MARIA ESTHER (MS)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ESTHER
Last Name:MEDINA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5881 NW 151ST ST STE 103
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2455
Mailing Address - Country:US
Mailing Address - Phone:786-703-4154
Mailing Address - Fax:786-332-3240
Practice Address - Street 1:5881 NW 151ST ST STE 103
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2455
Practice Address - Country:US
Practice Address - Phone:786-703-4154
Practice Address - Fax:786-332-3240
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL760121200Medicaid