Provider Demographics
NPI:1760171649
Name:MOLINA, LEYDA MARIA (APRN)
Entity Type:Individual
Prefix:
First Name:LEYDA
Middle Name:MARIA
Last Name:MOLINA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 NW 14TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-1673
Mailing Address - Country:US
Mailing Address - Phone:305-243-2196
Mailing Address - Fax:305-243-3687
Practice Address - Street 1:1321 NW 14TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-1673
Practice Address - Country:US
Practice Address - Phone:305-243-2196
Practice Address - Fax:305-243-3687
Is Sole Proprietor?:No
Enumeration Date:2023-05-05
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11009029363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner