Provider Demographics
NPI:1114905726
Name:MOLINA, ANGEL MANUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:MANUEL
Last Name:MOLINA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:230 CALLE TURPIAL
Mailing Address - Street 2:MONTEHIEDRA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7112
Mailing Address - Country:US
Mailing Address - Phone:787-790-0080
Mailing Address - Fax:787-720-0620
Practice Address - Street 1:9 AVE ESMERALDA
Practice Address - Street 2:URB. MUNOZ RIVERA
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-4430
Practice Address - Country:US
Practice Address - Phone:787-790-0080
Practice Address - Fax:787-720-0620
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-04
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR9402207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR82850Medicare PIN