MEDICARE: DR. RHONDA J MEDINA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	35.077824	OH

General Provider Information

NPI Number	:	1306838867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RHONDA J MEDINA M.D.

Provider Business Mailing Address
First Line	:	1001 BELLEFONTAINE AVE
Second Line	:
City	:	LIMA
State	:	OH
Zip	:	45804-2800
Country	:	US
Telephone Number	:	419-998-4575
Fax Number	:	419-998-4586

Provider Business Practice Location Address
First Line	:	1220 E ELM ST STE 101
Second Line	:
City	:	LIMA
State	:	OH
Zip	:	45804-2803
Country	:	US
Telephone Number	:	419-998-8245
Fax Number	:	419-998-8247

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	01/04/2021

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1518984137 — DR. KENNETH E STANLEY MD
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1639283914 — DR. FADI ABBASS M.D.
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Directions to “ DR. RHONDA J MEDINA M.D.” Practice Location

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