Provider Demographics
NPI:1336300839
Name:MOLINET MD PA
Entity Type:Organization
Organization Name:MOLINET MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ MOLINET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-804-1997
Mailing Address - Street 1:PO BOX 13076
Mailing Address - Street 2:
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-7076
Mailing Address - Country:US
Mailing Address - Phone:561-598-6555
Mailing Address - Fax:561-598-6600
Practice Address - Street 1:3015 S CONGRESS AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-2111
Practice Address - Country:US
Practice Address - Phone:561-598-6555
Practice Address - Fax:561-598-6600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-18
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME89177207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAM088AMedicare PIN