Provider Demographics
NPI:1194783027
Name:MOLTHROP, DAVID C JR (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
Last Name:MOLTHROP
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 102222
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2222
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:239-278-3350
Practice Address - Street 1:460 N ORLANDO AVE
Practice Address - Street 2:STE 200 BLDG D
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2988
Practice Address - Country:US
Practice Address - Phone:407-898-5452
Practice Address - Fax:844-722-1185
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2022-09-02
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Provider Licenses
StateLicense IDTaxonomies
FLME65259207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL376004900Medicaid
FL23613YMedicare PIN
FL376004900Medicaid