MEDICARE: DESDEMORA CELESTINA MOLINA LMT

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	225700000X	Massage Therapist	MA97145	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MA97145	OTHER	FL	LICENSED MASSAGE THERAPIST

General Provider Information

NPI Number	:	1922707397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DESDEMORA CELESTINA MOLINA LMT

Provider Business Mailing Address
First Line	:	14408 SW 159TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33177-6899
Country	:	US
Telephone Number	:	772-501-1007
Fax Number	:

Provider Business Practice Location Address
First Line	:	20555 OLD CUTLER RD
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33189-2455
Country	:	US
Telephone Number	:	772-501-1007
Fax Number	:

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

Provider Enumeration Date	:	02/24/2023
Last Update Date	:	12/12/2025

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