Healthcare Provider Details

I. General information

NPI: 1003937244
Provider Name (Legal Business Name): TOMAS RODRIGUEZ MOLINET MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1070 N STONE ST STE D
DELAND FL
32720-0824
US

IV. Provider business mailing address

PO BOX 945385
ATLANTA GA
30394-5385
US

V. Phone/Fax

Practice location:
  • Phone: 386-822-9112
  • Fax: 386-424-5249
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number234802
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number25049
License Number StateWV
# 3
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberS8378
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME89177
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: