Provider Demographics
NPI:1912357054
Name:MOLERO, ANDREA JULIANA
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:JULIANA
Last Name:MOLERO
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 1:17210 NW 64TH AVE APT 307
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-6326
Mailing Address - Country:US
Mailing Address - Phone:347-854-5069
Mailing Address - Fax:
Practice Address - Street 1:17210 NW 64TH AVE APT 307
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-6326
Practice Address - Country:US
Practice Address - Phone:347-854-5069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst