MEDICARE: ARMANI MEDINA ATC

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	2255A2300X	Athletic Trainer	5661	FL

General Provider Information

NPI Number	:	1982340089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARMANI MEDINA ATC

Provider Business Mailing Address
First Line	:	4304 SW 68TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-4750
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6855 SW 152ND ST
Second Line	:
City	:	PALMETTO BAY
State	:	FL
Zip	:	33157-2623
Country	:	US
Telephone Number	:	786-426-8672
Fax Number	:

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

Provider Enumeration Date	:	05/11/2022
Last Update Date	:	05/11/2022

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Directions to “ ARMANI MEDINA ATC” Practice Location

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