Provider Demographics
NPI:1588204176
Name:MOLINA, SOFIA (APRN)
Entity type:Individual
Prefix:
First Name:SOFIA
Middle Name:
Last Name:MOLINA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SOFIA
Other - Middle Name:ARACELY
Other - Last Name:MOLINA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:7950 SW 9TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4253
Mailing Address - Country:US
Mailing Address - Phone:786-473-2605
Mailing Address - Fax:
Practice Address - Street 1:1801 NW 9TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1101
Practice Address - Country:US
Practice Address - Phone:305-355-5220
Practice Address - Fax:305-355-5202
Is Sole Proprietor?:No
Enumeration Date:2020-01-10
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11002338363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily