MEDICARE: NATASHA A MOLINA FNP-BC

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	363LF0000X	Family Nurse Practitioner	RN9235138	FL

General Provider Information

NPI Number	:	1225469414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATASHA A MOLINA FNP-BC

Provider Business Mailing Address
First Line	:	5650 SEAPINE ROAD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33417
Country	:	US
Telephone Number	:	561-313-8466
Fax Number	:

Provider Business Practice Location Address
First Line	:	5650 SEAPINE RD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33417-5707
Country	:	US
Telephone Number	:	561-313-8466
Fax Number	:

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

Provider Enumeration Date	:	12/12/2013
Last Update Date	:	12/12/2013

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