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Teodoro Medina, MD
General Practice Physician in Davenport, Florida
NPI 1093852113

Teodoro Medina is a General Practice Physician based in Orlando, FL. Teodoro Medina practices in Davenport, FL and has the professional credentials of MD. The NPI Number for Teodoro Medina is 1093852113 and holds a License No. 14489 (Florida).

The current practice location address for Teodoro Medina is 111 Webb Dr, Davenport, FL and can be reached out via phone at 863-421-9447 and via fax at 863-421-1806.

Location: 111 Webb Dr, Davenport, FL, 32821
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1093852113
Provider Name
Teodoro Medina
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
111 Webb Dr, Davenport, FL, 32821
Phone Number
863-421-9447
Fax Number
863-421-1806
Provider Enumeration Date
01/30/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
TW49T 01 FL FL BLUE
institution
Provider Business Practice Location Address Details
Address
111 Webb Dr
City
Davenport
State
Florida
Zip
33837-3962
Phone Number
863-421-9447
Fax Number
863-421-1806
person
Provider Business Mailing Address Details
Address
111 Webb Dr
City
Davenport
State
Florida
Zip
33837-3962
Phone Number
863-421-9447
Fax Number
863-421-1806
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
14489 ()
Definition
Definition to come...
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