Provider Demographics
NPI:1235611815
Name:MOLINA, PETER DANGER (PA-C)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:DANGER
Last Name:MOLINA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8181 NW 154TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5861
Mailing Address - Country:US
Mailing Address - Phone:305-558-3724
Mailing Address - Fax:786-260-0019
Practice Address - Street 1:1190 NW 95TH ST STE 200
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33150-2064
Practice Address - Country:US
Practice Address - Phone:305-691-2550
Practice Address - Fax:305-696-4610
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA91114812081P2900X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine