Healthcare Provider Details

I. General information

NPI: 1063942381
Provider Name (Legal Business Name): YOLANDA MOLINARIS M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2017
Last Update Date: 03/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 CYPRESS PKWY
KISSIMMEE FL
34759-3328
US

IV. Provider business mailing address

PO BOX 616788
ORLANDO FL
32861-6788
US

V. Phone/Fax

Practice location:
  • Phone: 407-483-1400
  • Fax: 407-483-1405
Mailing address:
  • Phone: 407-483-1400
  • Fax: 407-483-1405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME118090
License Number StateFL

VIII. Authorized Official

Name: DR. YOLANDA MOLINARIS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 407-265-2100