MEDICARE: DR. RODOLFO MOLINA M.D.

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	207Q00000X	Family Medicine Physician	ME47190	FL

General Provider Information

NPI Number	:	1598899684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RODOLFO MOLINA M.D.

Provider Business Mailing Address
First Line	:	4055 VENTURA AVE
Second Line	:
City	:	COCONUT GROVE
State	:	FL
Zip	:	33133-6332
Country	:	US
Telephone Number	:	305-557-2277
Fax Number	:	305-557-2278

Provider Business Practice Location Address
First Line	:	3805 W 20TH AVE STE 105
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-4532
Country	:	US
Telephone Number	:	305-557-2277
Fax Number	:	305-557-2278

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

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	07/09/2007

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