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General NPI Number Information
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NPI Number | 1346547957
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Entity Type | Organization
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Legal Business Name | MEDICAL SPECIALISTS AND WELLNESS CENTER OF SOUTH FLORIDA, LLC
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Dates
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Enumeration Date | 02/16/2011
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Last Update Date | 02/16/2011
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Provider Practice Location Address
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Address Line | 20900 BISCAYNE BLVD
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City | AVENTURA
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State | FL
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Zip | 33180-1407
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Country | US
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Telephone | 609-213-6288
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Fax |
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Provider Business Mailing Address
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Address Line | 701 S OLIVE AVE APT. 2109
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-6104
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Country | US
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Telephone | 609-213-6288
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. FRANCISCO MOLINA
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Credential | M.D.
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Telephone | 609-213-6288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME104792
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License Number State | FL
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