MEDICARE: STEPHANIE MOLINA

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1093508830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE MOLINA

Provider Business Mailing Address
First Line	:	4371 COVENTRY POINTE WAY
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-4916
Country	:	US
Telephone Number	:	561-236-5138
Fax Number	:

Provider Business Practice Location Address
First Line	:	4371 COVENTRY POINTE WAY
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-4916
Country	:	US
Telephone Number	:	561-236-5138
Fax Number	:

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

Provider Enumeration Date	:	05/24/2025
Last Update Date	:	05/28/2025

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Directions to “ STEPHANIE MOLINA ” Practice Location

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