MEDICARE: ROMELVI MEDRANO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	101YM0800X	Mental Health Counselor	MH24586	FL

General Provider Information

NPI Number	:	1720713548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROMELVI MEDRANO

Provider Business Mailing Address
First Line	:	545 S KELLER RD UNIT 1308
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32810-6228
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1277 N SEMORAN BLVD STE 112
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32807-3573
Country	:	US
Telephone Number	:	800-457-4457
Fax Number	:	800-443-6422

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2022
Last Update Date	:	01/07/2025

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Directions to “ ROMELVI MEDRANO ” Practice Location

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