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General NPI Number Information
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NPI Number | 1689541724
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Entity Type | Organization
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Legal Business Name | MOLINA HOME CARE LLC
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Dates
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Enumeration Date | 10/22/2025
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 13180 N CLEVELAND AVE STE 237
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City | NORTH FORT MYERS
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State | FL
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Zip | 33903-6226
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Country | US
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Telephone | 239-703-0314
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Fax | 239-425-8911
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Provider Business Mailing Address
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Address Line | 13180 N CLEVELAND AVE STE 237
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City | NORTH FORT MYERS
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State | FL
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Zip | 33903-6226
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Country | US
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Telephone | 239-703-0314
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Fax | 239-425-8911
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Authorized Official
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Title or Position | OWNER
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Name | CAROLINA COISCOU
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Credential | RN
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Telephone | 239-297-4959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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