Individual
LIVAN MOLLINEDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
4423 PARK BLVD N, PINELLAS PARK, FL 33781-3540
(727) 827-2825
Mailing address
3757 40TH AVE N, SAINT PETERSBURG, FL 33714-4422
(727) 768-6722
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA 70586
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA 70586
MEDICAL LICENSE
FL
Enumeration date
10/05/2012
Last updated
10/05/2012
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