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General NPI Number Information
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NPI Number | 1508357831
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Entity Type | Individual
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Provider Name | MEDEONA GJERGJINDREAJ DO
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Gender | Female
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Dates
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Enumeration Date | 05/22/2018
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Last Update Date | 07/08/2024
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Provider Practice Location Address
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Address Line | 4300 ALTON RD STE 2070
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City | MIAMI BEACH
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State | FL
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Zip | 33140-2948
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Country | US
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Telephone | 305-460-1140
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Fax |
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Provider Business Mailing Address
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Address Line | 1420 NE MIAMI PL APT 1419
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City | MIAMI
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State | FL
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Zip | 33132-1354
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Country | US
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Telephone | 305-804-4918
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | OS21223
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License Number State | FL
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