Provider Demographics
NPI:1437698834
Name:MOLL, MARIA KARLA (NP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:KARLA
Last Name:MOLL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14314 SPORTS CLUB WAY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-6985
Mailing Address - Country:US
Mailing Address - Phone:786-413-4049
Mailing Address - Fax:
Practice Address - Street 1:14314 SPORTS CLUB WAY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-6985
Practice Address - Country:US
Practice Address - Phone:786-413-4049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-17
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9338011363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily