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General NPI Number Information
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NPI Number | 1255449047
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Entity Type | Individual
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Provider Name | VICTOR MEDINA SERALDE M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 01/10/2013
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Provider Practice Location Address
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Address Line | 3750 US HIGHWAY 27 N STE 4F
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City | SEBRING
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State | FL
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Zip | 33870-1658
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Country | US
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Telephone | 863-382-4949
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Fax | 863-382-3811
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Provider Business Mailing Address
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Address Line | 3750 US HIGHWAY 27 N STE 4F
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City | SEBRING
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State | FL
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Zip | 33870-1658
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Country | US
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Telephone | 863-382-4949
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Fax | 863-382-3811
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME0041355
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License Number State | FL
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