Provider Demographics
NPI:1760865067
Name:MOLINA ARIZA, YUDISBEL
Entity Type:Individual
Prefix:DR
First Name:YUDISBEL
Middle Name:
Last Name:MOLINA ARIZA
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 1:14941 SW 8TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33194-2759
Mailing Address - Country:US
Mailing Address - Phone:305-302-7539
Mailing Address - Fax:
Practice Address - Street 1:1508 WHITEHALL DR APT 303
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33324-6617
Practice Address - Country:US
Practice Address - Phone:305-302-7539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-04
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 213861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice