Healthcare Provider Details

I. General information

NPI: 1508795196
Provider Name (Legal Business Name): VICTOR GABRIEL MEDINA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HILL BROTHERS 393 CALLE 11
SAN JUAN PR
00924
US

IV. Provider business mailing address

HILL BROTHERS 393 CALLE 11
SAN JUAN PR
00924
US

V. Phone/Fax

Practice location:
  • Phone: 787-679-5797
  • Fax:
Mailing address:
  • Phone: 787-679-5797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: