Mary L Molloy, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9105263 Issued in FL

Practice address

8931 Colonial Center Dr
Suite 300
Fort Myers, FL 33905-7809

Phone

(239) 938-0800

Fax

(239) 938-0890

NPI assigned

Dec 23, 2010

Last updated

Dec 23, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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

• Florida Cancer Specialists & Research Institute, LLC

  • Medical Oncology Physician
  • Cape Coral, FL
  • NPI 1760590962
  Medicare reassignment NPD

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

{
    "created_epoch": "1293062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293062400000",
    "number": "1205130739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4371 VERONICA S SHOEMAKER BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339162216",
            "telephone_number": "239-274-8200",
            "fax_number": "239-278-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8931 COLONIAL CENTER DR",
            "address_2": "SUITE 300",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339057809",
            "telephone_number": "239-938-0800",
            "fax_number": "239-938-0890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLLOY",
        "first_name": "MARY",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-23",
        "last_updated": "2010-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9105263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dannisel Molina Morales
• Yanela Molina- Chuy, APRN
• Angela Maria Molina, LMHC
• Joseph Anthony Molina, PT, DPT
• Brian Michael Molloy
• Momentum ABA Services LLC
• Manuel J Mon, M.D.
• Holly Monaco, PA-C
• Melissa Christine Monaco, LMT
• Kerry Monahan, APRN

• Physician Assistant in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.