Healthcare Provider Details

I. General information

NPI: 1639594633
Provider Name (Legal Business Name): MOLLY K CHILDERS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2014
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 TAMPA GENERAL CIR
TAMPA FL
33606-3571
US

IV. Provider business mailing address

501 6TH ST S APT 922
ST PETERSBURG FL
33701-4630
US

V. Phone/Fax

Practice location:
  • Phone: 813-821-8038
  • Fax: 813-974-0483
Mailing address:
  • Phone: 727-767-7322
  • Fax: 727-767-8612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101259324
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME149936
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberME149936
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: