Healthcare Provider Details

I. General information

NPI: 1164025052
Provider Name (Legal Business Name): LISETTE MOLINA APRN, FNP-BC, L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2020
Last Update Date: 10/12/2026
Certification Date: 10/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7003 NW 11TH PL STE 3&4
GAINESVILLE FL
32605-3176
US

IV. Provider business mailing address

11137 NW 18TH RD
GAINESVILLE FL
32606-9261
US

V. Phone/Fax

Practice location:
  • Phone: 786-292-3999
  • Fax:
Mailing address:
  • Phone: 786-930-3328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP4206
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11029781
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: