Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | APRN11003688 | FL |
N | 225700000X | Massage Therapist | MA51731 | FL |
NPI | 1003116286 |
---|---|
Provider Name | Luis Mario Molina |
First Address | Miami, FL 33185-5035 |
Second Address | Miami, FL 33185-5035 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2010 |
Last Update Date | 09/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
APRN11003688 | ADVANCE PRACTICE REGISTERED NURSE (01) | FL |
RN9396435 | REGISTERED NURSE (01) | FL |