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General NPI Number Information
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NPI Number | 1477433118
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Entity Type | Individual
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Provider Name | MARIA RICHIEZ MEDINA
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Gender | Female
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Dates
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Enumeration Date | 09/04/2025
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 5449 S SEMORAN BLVD STE 19B
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City | ORLANDO
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State | FL
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Zip | 32822-1778
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Country | US
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Telephone | 407-723-5264
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Fax |
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Provider Business Mailing Address
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Address Line | 81 TROTTERS CIR
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City | KISSIMMEE
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State | FL
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Zip | 34743-7729
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Country | US
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Telephone | 407-910-7629
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Fax |
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH33484
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License Number State | FL
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