Provider Demographics
NPI:1033754833
Name:MOLINA, XIOMARA S (BS)
Entity Type:Individual
Prefix:
First Name:XIOMARA
Middle Name:S
Last Name:MOLINA
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 6 BOX 93272
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-9660
Mailing Address - Country:US
Mailing Address - Phone:787-630-8101
Mailing Address - Fax:
Practice Address - Street 1:URB JARDINEZ HATO ARRIBA CARR 129 R490 INT KM 1.3
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-630-8101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-15
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program