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General NPI Number Information
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NPI Number | 1255126876
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Entity Type | Individual
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Provider Name | SUSAN MOLINA RN BSN
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Gender | Female
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Dates
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Enumeration Date | 04/14/2025
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 4101 COLLEGE ST STE 1
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City | JACKSONVILLE
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State | FL
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Zip | 32205-5318
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Country | US
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Telephone | 904-387-0370
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Fax | 904-387-0156
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Provider Business Mailing Address
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Address Line | 11229 BELMONT OAKS DR
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City | JACKSONVILLE
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State | FL
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Zip | 32220-3700
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Country | US
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Telephone | 440-570-5438
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN368333
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 9323314
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License Number State | FL
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