Healthcare Provider Details

I. General information

NPI: 1831715010
Provider Name (Legal Business Name): LARA CESAR GABAS MOLINA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2020
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E ROLLINS ST
ORLANDO FL
32803-1248
US

IV. Provider business mailing address

250 HARRISON ST
TITUSVILLE FL
32780-5094
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-0410
  • Fax: 407-303-0417
Mailing address:
  • Phone: 212-686-8683
  • Fax: 321-268-4922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME165919
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberME165919
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: