Individual
CARLOS MOLINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
297 SW TWIG AVE, PORT ST LUCIE, FL 34983-3033
(561) 886-8163
Mailing address
297 SW TWIG AVE, PORT ST LUCIE, FL 34983-3033
(561) 886-8163
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
M2150757090000
FL
Other
Enumeration date
09/18/2025
Last updated
09/18/2025
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