MEDICARE: INGRID TATIANA DURAN MOLINA APRN

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	363LF0000X	Family Nurse Practitioner	APRN11010792	FL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11010792	FL

General Provider Information

NPI Number	:	1215527965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	INGRID TATIANA DURAN MOLINA APRN

Provider Business Mailing Address
First Line	:	16151 SW 83RD ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33193-3051
Country	:	US
Telephone Number	:	786-523-6721
Fax Number	:

Provider Business Practice Location Address
First Line	:	2010 NW 150TH AVE STE 120
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33028-2888
Country	:	US
Telephone Number	:	954-719-6280
Fax Number	:

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

Provider Enumeration Date	:	01/26/2021
Last Update Date	:	04/28/2025

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