Provider Demographics
NPI:1013000181
Name:MARIANI MOLINI, PEDRO ANTONIO SR (MD)
Entity Type:Individual
Prefix:MR
First Name:PEDRO
Middle Name:ANTONIO
Last Name:MARIANI MOLINI
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 5103
Mailing Address - Street 2:PMB 72
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623
Mailing Address - Country:US
Mailing Address - Phone:787-255-2775
Mailing Address - Fax:787-254-1920
Practice Address - Street 1:CAR 101 KM 16-2 SECTOR LOS ARENAS
Practice Address - Street 2:
Practice Address - City:BOQUERON
Practice Address - State:PR
Practice Address - Zip Code:00623
Practice Address - Country:US
Practice Address - Phone:787-255-2775
Practice Address - Fax:787-254-1920
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR15185208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
0022693Medicare ID - Type Unspecified
I25555Medicare UPIN