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General NPI Number Information
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NPI Number | 1073088332
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Entity Type | Individual
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Provider Name | JUAN CARLOS MOLINA SOTO
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Gender | Male
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Dates
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Enumeration Date | 10/12/2018
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | APS CLINICS OF PUERTO RICO EDIFICIO PLAZA DEL MAR CARR 107 KM 2.3
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City | AGUADILLA
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State | PR
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Zip | 00603
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Country | US
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Telephone | 787-641-9133
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Fax |
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Provider Business Mailing Address
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Address Line | CALLE COLON #4 CARR. 115 KM 24.5 EDIF. AGUADA COMPLEX 2DO PISO SUITE 5
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City | AGUADA
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State | PR
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Zip | 00602
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Country | US
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Telephone | 787-487-9086
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 22249
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License Number State | PR
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