Molina Heathcare of Florida Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MOLINA HEATHCARE OF FLORIDA INC

Doing business as

Molina Medical

Practice address

3514 Broadway
Riviera Beach, FL 33404-2332

Phone

(561) 223-4573

Fax

(877) 860-2271

NPI assigned

Mar 13, 2012

Organization subpart

No

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

Authorized official

Name

Gloria Calderon

Title

Vice President, Clinic Operations

Phone

(562) 491-7053

Specialties & licenses 2

Addresses

Other names 1

• Molina Medical Doing business as

Locations

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

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375833600000",
    "number": "1336414119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE",
            "address_2": "SUITE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024317",
            "telephone_number": "562-499-6191",
            "fax_number": "562-299-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3514 BROADWAY",
            "city": "RIVIERA BEACH",
            "state": "FL",
            "postal_code": "334042332",
            "telephone_number": "561-223-4573",
            "fax_number": "877-860-2271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOLINA HEATHCARE OF FLORIDA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-13",
        "last_updated": "2013-08-07",
        "status": "A",
        "authorized_official_last_name": "CALDERON",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "VICE PRESIDENT, CLINIC OPERATIONS",
        "authorized_official_telephone_number": "562-491-7053"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Molina Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ljubica Miskovic, PSYD.
• Engrin Mitchell, RN
• Mobile Practitioner Services Inc.
• Bayard Lloyd Moffitt, M.D.
• Javnybel Mojica-Jimenez
• Dagmaris Molina Lopez, RBT, ITDS
• Marcie Monroe
• Ricardo Jose Montalvan Alamo
• Moore Care Assisted Living Facility
• Argentina Yvonne Moore, B.A.

• Family Medicine Physician in Riviera Beach, FL
• Providers in Riviera Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.