Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | CH13002 | FL |
NPI | 1134769987 |
---|---|
Provider Name | Dr. Alan Molina |
First Address | Wesley Chapel, FL 33543-7676 |
Second Address | Tampa, FL 33603-4338 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2020 |
Last Update Date | 09/01/2020 |