MEDICARE: MEDINA HEALTHCARE LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
3	208D00000X	General Practice Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871361105
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDINA HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	766 E 10TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-3636
Country	:	US
Telephone Number	:	786-398-1326
Fax Number	:	786-590-1033

Provider Business Practice Location Address
First Line	:	766 E 10TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-3636
Country	:	US
Telephone Number	:	786-398-1326
Fax Number	:	786-590-1033

Authorized Official
Title or Position	:	CEO
Name	:	YURITZA MEDINA RAMIREZ
Credential	:	DNP, PMHNP-BC, FNP-C
Telephone Number	:	786-398-1326

Provider Enumeration Date	:	12/15/2023
Last Update Date	:	01/08/2026

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