Healthcare Provider Details

I. General information

NPI: 1992477699
Provider Name (Legal Business Name): EDUARDO MOLINA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2021
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8130 ROYAL PALM BLVD STE 105
CORAL SPRINGS FL
33065-5703
US

IV. Provider business mailing address

8130 ROYAL PALM BLVD STE 105
CORAL SPRINGS FL
33065-5703
US

V. Phone/Fax

Practice location:
  • Phone: 954-344-6550
  • Fax:
Mailing address:
  • Phone: 954-344-6550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: