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General NPI Number Information
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NPI Number | 1386341600
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Entity Type | Organization
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Legal Business Name | MOLINAS MEDICAL SERVICES LLC
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Dates
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Enumeration Date | 02/08/2023
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Last Update Date | 02/27/2024
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Provider Practice Location Address
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Address Line | 111 EVERETT AVE STE 1A
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City | CHELSEA
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State | MA
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Zip | 02150-2370
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Country | US
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Telephone | 857-588-2175
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Fax |
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Provider Business Mailing Address
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Address Line | 99 TUDOR ST
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City | CHELSEA
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State | MA
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Zip | 02150-2152
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ISRAEL MOLINA
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Credential | MD
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Telephone | 617-466-2687
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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