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NPI Code Detail

MEDICARE: MOLLY ANN KIRK

MEDICARE: MOLLY ANN KIRK
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
1314000000XSkilled Nursing FacilityPTA24029FL

General Provider Information

NPI Number : 1881032340
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOLLY ANN KIRK
Provider Business Mailing Address
First Line : 1775 HUNTINGTON LN
Second Line :
City : ROCKLEDGE
State : FL
Zip : 32955-3136
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1775 HUNTINGTON LN
Second Line :
City : ROCKLEDGE
State : FL
Zip : 32955-3136
Country : US
Telephone Number : 321-632-7341
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2013
Last Update Date : 06/06/2013

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Directions to “ MOLLY ANN KIRK ” Practice Location

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