Healthcare Provider Details

I. General information

NPI: 1033526140
Provider Name (Legal Business Name): MAIBYS MOLINA ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2014
Last Update Date: 07/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2140 W 68TH ST
HIALEAH FL
33016-1815
US

IV. Provider business mailing address

2140 W 68TH ST
HIALEAH FL
33016-1815
US

V. Phone/Fax

Practice location:
  • Phone: 305-332-2065
  • Fax:
Mailing address:
  • Phone: 305-332-2065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9310274
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number9310274
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: