MEDICARE: DR. ROSARIO G. MOLINA DMD. (DENTIST)

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	122300000X	Dentist	DN9515	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912231549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROSARIO G. MOLINA DMD. (DENTIST)

Provider Business Mailing Address
First Line	:	4835 E 4TH AVE
Second Line	:	SUITE A
City	:	HIALEAH
State	:	FL
Zip	:	33013
Country	:	US
Telephone Number	:	305-685-5133
Fax Number	:	305-685-8076

Provider Business Practice Location Address
First Line	:	4835 E 4TH AVE
Second Line	:	SUITE A
City	:	HIALEAH
State	:	FL
Zip	:	33013
Country	:	US
Telephone Number	:	305-685-5133
Fax Number	:	305-685-8076

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

Provider Enumeration Date	:	09/30/2009
Last Update Date	:	09/30/2009

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