Healthcare Provider Details

I. General information

NPI: 1275376196
Provider Name (Legal Business Name): ELIZABETH LENA MOLNAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2024
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2305 GLENWOOD DR
WINTER PARK FL
32792-3313
US

IV. Provider business mailing address

2305 GLENWOOD DR
WINTER PARK FL
32792-3313
US

V. Phone/Fax

Practice location:
  • Phone: 407-316-2873
  • Fax:
Mailing address:
  • Phone: 407-558-1807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-535014
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: