Provider Demographics
NPI:1700681343
Name:MOLINA, BLAIRE EIIZABETH (APRN)
Entity type:Individual
Prefix:DR
First Name:BLAIRE
Middle Name:EIIZABETH
Last Name:MOLINA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 BARBAROSSA AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-3504
Mailing Address - Country:US
Mailing Address - Phone:305-542-2632
Mailing Address - Fax:
Practice Address - Street 1:414 BARBAROSSA AVE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-3504
Practice Address - Country:US
Practice Address - Phone:305-542-2632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11037203363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily