Individual provider Active NPI

Luis Mario Molina, MA

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1003116286
Registry record updated Feb 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11003668 Issued in FL
Practice address
15736 SW 50TH Ter
Miami, FL 33185-5035
Phone
(786) 294-2772
NPI assigned
Oct 22, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X APRN11003688 FL
Massage Therapist 225700000X MA51731 FL
Family Nurse Practitioner 363LF0000X APRN11003668 FL Primary

Addresses

Primary practice location

15736 SW 50TH Ter
Miami, FL 33185-5035

Mailing address

15736 SW 50TH Ter
Miami, FL 33185-5035
Phone (786) 294-2772

Other identifiers 2

IdentifierTypeStateIssuer
APRN11003688OtherFLADVANCE PRACTICE REGISTERED NURSE
RN9396435OtherFLREGISTERED NURSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220309002115 FL Practitioner - Nurse Practitioner 0547655565 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11003688FLMDFamily Medicine Physician
MA51731FLMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Es Rehab Professional Center, Inc Single Specialty CurrentSince Dec 25, 2021 Accepting new patients

Locations

5600 SW 135th Ave
Ste 216
Miami, FL 33183
Phone (786) 536-6196

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1003116286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15736 SW 50TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331855035",
            "telephone_number": "786-294-2772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15736 SW 50TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331855035",
            "telephone_number": "786-294-2772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLINA",
        "first_name": "LUIS",
        "middle_name": "MARIO",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-22",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "APRN11003688",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA51731",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11003668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCE PRACTICE REGISTERED NURSE",
            "identifier": "APRN11003688",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "RN9396435",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.