Provider Demographics
NPI:1215693783
Name:MOLINA SOLTERO, RENE L
Entity type:Individual
Prefix:
First Name:RENE
Middle Name:L
Last Name:MOLINA SOLTERO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2018B SW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-1812
Mailing Address - Country:US
Mailing Address - Phone:786-712-4589
Mailing Address - Fax:
Practice Address - Street 1:2018B SW 4TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-1812
Practice Address - Country:US
Practice Address - Phone:786-712-4589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLJB317848374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician