Provider Demographics
NPI:1548218076
Name:MOLINA-MILLET, LEONARDO (MD)
Entity Type:Individual
Prefix:
First Name:LEONARDO
Middle Name:
Last Name:MOLINA-MILLET
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:PO BOX 1109
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00986-1109
Mailing Address - Country:US
Mailing Address - Phone:787-790-4176
Mailing Address - Fax:787-790-4176
Practice Address - Street 1:CALLE CARAZO #44
Practice Address - Street 2:SUITE 2A
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-790-4176
Practice Address - Fax:787-490-4176
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13062207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G99096Medicare UPIN
PREY718AMedicare PIN