Provider Demographics
NPI:1508277922
Name:ZAHARIS-MOLINA, ALISSA KRISTINE (ARNP)
Entity Type:Individual
Prefix:
First Name:ALISSA
Middle Name:KRISTINE
Last Name:ZAHARIS-MOLINA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 5TH ST S
Mailing Address - Street 2:DEPT #6500002705
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4804
Mailing Address - Country:US
Mailing Address - Phone:727-767-3051
Mailing Address - Fax:727-767-4970
Practice Address - Street 1:601 5TH ST S
Practice Address - Street 2:STE 306
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4804
Practice Address - Country:US
Practice Address - Phone:727-767-4170
Practice Address - Fax:727-767-4346
Is Sole Proprietor?:No
Enumeration Date:2014-05-20
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9206381363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014665900Medicaid