Provider Demographics
NPI:1851387567
Name:MOLINA, ANDRES DAVID (MD)
Entity Type:Individual
Prefix:
First Name:ANDRES
Middle Name:DAVID
Last Name:MOLINA
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 1:7 CALLE 3
Mailing Address - Street 2:VILLA LOS OLMOS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00901-2436
Mailing Address - Country:US
Mailing Address - Phone:803-439-3437
Mailing Address - Fax:
Practice Address - Street 1:7 CALLE 3
Practice Address - Street 2:VILLA LOS OLMOS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00901-2436
Practice Address - Country:US
Practice Address - Phone:803-439-3437
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16053208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice