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Organization
MOLINA PROVIDER CARE
Active
Organization
MOLINA PROVIDER CARE
Active
Other names
molina Provider Care
Organization subpart
No
Provider details
NPI number
Authorized official
MARANGELY MOLINA (DIRECTOR)
(407) 334-1166
Entity
Organization
Contact information
Practice address
2544 ISABELA TER, KISSIMMEE, FL 34743-5816
(407) 334-1166
Mailing address
2544 ISABELA TER, KISSIMMEE, FL 34743-5816
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18003090
—
FL
Enumeration date
04/29/2020
Last updated
02/25/2021
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