Provider Demographics
NPI:1346353570
Name:MOLERA, FEDERICO FERNANDO (MD)
Entity Type:Individual
Prefix:
First Name:FEDERICO
Middle Name:FERNANDO
Last Name:MOLERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7263 WELLINGTON NECK RD
Mailing Address - Street 2:
Mailing Address - City:FRANKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23354
Mailing Address - Country:US
Mailing Address - Phone:757-442-5800
Mailing Address - Fax:
Practice Address - Street 1:9507 ROGERS AVE
Practice Address - Street 2:
Practice Address - City:NASSAWADOX
Practice Address - State:VA
Practice Address - Zip Code:23413
Practice Address - Country:US
Practice Address - Phone:757-414-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101036360207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB10293Medicare UPIN