Provider Demographics
NPI:1891252029
Name:MOLINA, FERGIE ALEXA (DMD)
Entity Type:Individual
Prefix:MS
First Name:FERGIE
Middle Name:ALEXA
Last Name:MOLINA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16782 SW 88TH ST UNIT 382
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-5934
Mailing Address - Country:US
Mailing Address - Phone:786-378-9028
Mailing Address - Fax:
Practice Address - Street 1:9075 SW 162ND AVE STE 110&112
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-6437
Practice Address - Country:US
Practice Address - Phone:786-732-0802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-24
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN273211223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry