Healthcare Provider Details

I. General information

NPI: 1588585301
Provider Name (Legal Business Name): MEDEFFECTIVE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2026
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3084 S JOG RD
GREENACRES FL
33467-2053
US

IV. Provider business mailing address

1169 PENINSULA WAY
GREENACRES FL
33413-3009
US

V. Phone/Fax

Practice location:
  • Phone: 562-635-5533
  • Fax:
Mailing address:
  • Phone: 561-635-5533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. CARLOS ALBERTO COLOMA
Title or Position: CEO
Credential: APRN
Phone: 561-635-5533