Healthcare Provider Details

I. General information

NPI: 1710804745
Provider Name (Legal Business Name): LESBIA MAGALY BARAJAS MOLINA PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 W 84TH ST STE 107
HIALEAH FL
33016-5771
US

IV. Provider business mailing address

5427 NW 200TH RD
MIAMI GARDENS FL
33055-4617
US

V. Phone/Fax

Practice location:
  • Phone: 786-416-7601
  • Fax:
Mailing address:
  • Phone: 954-655-3208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3112
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: