Healthcare Provider Details

I. General information

NPI: 1740194422
Provider Name (Legal Business Name): MOLINA HEALTHCARE OF FLORIDA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

8400 NW 33RD ST STE 120A
DORAL FL
33122-1937
US

IV. Provider business mailing address

8400 NW 33RD ST STE 120A
DORAL FL
33122-1937
US

V. Phone/Fax

Practice location:
  • Phone: 562-542-2188
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number StateNULL

VIII. Authorized Official

Name: MELISSA DOMINGUEZ
Title or Position: MANAGER GOVT. CONTRACTS
Credential:
Phone: 562-542-2188