Healthcare Provider Details

I. General information

NPI: 1205834975
Provider Name (Legal Business Name): REYNALDO MOLINA FRANCISCO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

Provider Other Name: REY MOLINA FRANCISCO MD

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5265 PROVIDENCE RD STE 505
VIRGINIA BEACH VA
23464-4206
US

IV. Provider business mailing address

5265 PROVIDENCE RD STE 505
VIRGINIA BEACH VA
23464-4206
US

V. Phone/Fax

Practice location:
  • Phone: 757-495-9525
  • Fax: 757-495-8910
Mailing address:
  • Phone: 757-495-9525
  • Fax: 757-495-8910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberVA0101028226
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: