Ivanelle Denise Medina, B.S., M.S.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3076 Issued in PR

Practice address

203 Galeria de Suchville
Guaynabo, PR 00966

Phone

(787) 231-6399

NPI assigned

Aug 28, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science, Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1699256529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB.REPARTO MARQUEZ",
            "address_2": "CALLE 9 G-21",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "00612",
            "telephone_number": "787-231-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 GALERIA DE SUCHVILLE",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00966",
            "telephone_number": "787-231-6399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Urb. Reparto Marquez Calle 9, G-21",
            "address_purpose": "LOCATION",
            "city": "Arecibo",
            "state": "PR",
            "postal_code": "00612",
            "country_code": "US",
            "telephone_number": "787-231-6399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "IVANELLE",
        "middle_name": "DENISE",
        "name_prefix": "Ms.",
        "credential": "B.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-28",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PR",
            "license": "3076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angel L Medina Mora, 1533P
• Javier Medina Morales, 1325P
• Jose A Medina Morales, 0839B
• Guillermo Medina Santiago, 1164P
• Manuel Andres Medina-Rodriguez, DC
• Julio C. Medina Sr., M.D.
• Lydia Carolyn Medina, O.D.
• Meditech LLC
• Medtronic Puerto Rico Operations
• Jossie Lu Mejia

• Speech-Language Pathologist in Guaynabo, PR
• Providers in Guaynabo, PR by specialty
• Speech-Language Pathologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.