Provider Demographics
NPI:1104299627
Name:MOLINA, STEFANIE (DC)
Entity type:Individual
Prefix:DR
First Name:STEFANIE
Middle Name:
Last Name:MOLINA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:STEFANIE
Other - Middle Name:
Other - Last Name:SALERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1336 NW 84TH AVE
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33126-1500
Mailing Address - Country:US
Mailing Address - Phone:305-800-7746
Mailing Address - Fax:305-709-2146
Practice Address - Street 1:1336 NW 84TH AVE
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33126-1500
Practice Address - Country:US
Practice Address - Phone:305-800-7746
Practice Address - Fax:305-709-2146
Is Sole Proprietor?:No
Enumeration Date:2015-11-05
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10687111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor