MEDICARE: SANDRA MOLANO

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	246XS1301X	Sonography Specialist/Technologist Cardiovascular
2	2471S1302X	Sonography Radiologic Technologist

General Provider Information

NPI Number	:	1871921023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA MOLANO

Provider Business Mailing Address
First Line	:	804 EMMETT ST
Second Line	:	STE A
City	:	KISSIMMEE
State	:	FL
Zip	:	34741-5434
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	804 EMMETT ST
Second Line	:	STE A
City	:	KISSIMMEE
State	:	FL
Zip	:	34741-5434
Country	:	US
Telephone Number	:	407-223-8603
Fax Number	:

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

Provider Enumeration Date	:	10/25/2013
Last Update Date	:	10/25/2013

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Directions to “ SANDRA MOLANO ” Practice Location

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