Provider Demographics
NPI:1437916699
Name:MOLINA, RICARDO ENRIQUE
Entity Type:Individual
Prefix:
First Name:RICARDO
Middle Name:ENRIQUE
Last Name:MOLINA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MORSE ST NE APT 515
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-7489
Mailing Address - Country:US
Mailing Address - Phone:202-924-5020
Mailing Address - Fax:
Practice Address - Street 1:300 MORSE ST NE APT 515
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-7489
Practice Address - Country:US
Practice Address - Phone:202-924-5080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-04
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant