Provider Demographics
NPI:1639878754
Name:MOLEDINA, FATEMAZAHRA
Entity Type:Individual
Prefix:
First Name:FATEMAZAHRA
Middle Name:
Last Name:MOLEDINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1721 SAN JACINTO CIR
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-6383
Mailing Address - Country:US
Mailing Address - Phone:407-416-8299
Mailing Address - Fax:
Practice Address - Street 1:1721 SAN JACINTO CIR
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-6383
Practice Address - Country:US
Practice Address - Phone:407-416-8299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician