Individual
MOLLY M MULLANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6555 CHESTER AVE STE 1, JACKSONVILLE, FL 32217-2279
(904) 265-8209
(904) 503-3577
Mailing address
2316 INDIAN SPRINGS DR, JACKSONVILLE, FL 32246-4184
(919) 302-9524
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9106964
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010438100
—
FL
01
—
PA9106964
MEDICAL LICENSE
FL
Enumeration date
11/19/2012
Last updated
10/07/2025
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