Provider Demographics
NPI:1922303536
Name:EDMUNDO L MOLINA M.D P.A
Entity Type:Organization
Organization Name:EDMUNDO L MOLINA M.D P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:EDMUNDO
Authorized Official - Middle Name:LAZARO
Authorized Official - Last Name:MOLINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-541-6415
Mailing Address - Street 1:3260 NW 7TH ST # 101
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-4102
Mailing Address - Country:US
Mailing Address - Phone:305-541-6415
Mailing Address - Fax:305-541-6655
Practice Address - Street 1:3260 NW 7TH ST # 101
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-4102
Practice Address - Country:US
Practice Address - Phone:305-541-6415
Practice Address - Fax:305-541-6655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-13
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty