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General NPI Number Information
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NPI Number | 1548481716
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Entity Type | Individual
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Provider Name | MEDINA H GREGORY DO
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Gender | Female
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 983 S BENEVA RD
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City | SARASOTA
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State | FL
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Zip | 34232-2401
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Country | US
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Telephone | 941-365-5355
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Fax |
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Provider Business Mailing Address
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Address Line | 1406 CREEK NINE DR
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City | NORTH PORT
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State | FL
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Zip | 34291-8036
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Country | US
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Telephone | 989-350-8266
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 5101015366
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License Number State | MI
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