Look up the most recent NPI and PECOS records

Amalia Jessica Medina

Behavior Technician

Behavioral Health & Social Service Providers

1800 SW 22nd Ave Apt 5, Miami, FL 33145-2140

PECOS Enrollment

Based on the most recent information from CMS, provider Amalia Jessica Medina does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1639639545
Provider Type
Individual
Full Name
Medina, Amalia Jessica
Gender
Female

Sole Proprietor
Yes
Enumeration Date
3/25/2019
Last Updated
3/25/2019

Contact Information

Practice Location

1800 SW 22nd Ave Apt 5, Miami, FL 33145-2140

(786) 803-3506

Unlisted Fax

Mailing Location

1800 SW 22nd Ave Apt 5, Miami, FL 33145-2140

(786) 803-3506

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106S00000X Primary	Description Behavior Technician Behavioral Health & Social Service Providers	License 18-59465 Florida

Provider Identifiers

ID	Description	Issuer
ID 023232800	Description Medicaid	Issuer Unlisted Florida

Amalia Jessica Medina

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Robaina, Maivelys

Alamo Gomez, Mariana

Guerra, Liset

Mesa, Reinelvy

Ley Jon, Dionne

Machin, Ernesto Alberto

Thompson, Nathalie Nicole

Castro Espinosa, Ana

Perez Quinones, Joel

Farinas Galban, Yaima