MEDICARE: DR. TOMAS RODRIGUEZ MOLINET MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	25049	WV
2	207R00000X	Internal Medicine Physician	234802	NY
3	207RG0100X	Gastroenterology Physician	S8378	TX
4	207RG0100X	Gastroenterology Physician	ME89177	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	WV1851A	OTHER	WV	MEDICARE PTAN
3	P01178675	OTHER	WV	RR MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	25049	OTHER	WV	STATE MEDICAL LICENSE

General Provider Information

NPI Number	:	1003937244
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TOMAS RODRIGUEZ MOLINET MD

Provider Business Mailing Address
First Line	:	PO BOX 945385
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30394-5385
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1070 N STONE ST STE D
Second Line	:
City	:	DELAND
State	:	FL
Zip	:	32720-0824
Country	:	US
Telephone Number	:	386-822-9112
Fax Number	:	386-424-5249

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	09/13/2024

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Directions to “ DR. TOMAS RODRIGUEZ MOLINET MD” Practice Location

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