Provider Demographics
NPI:1427533728
Name:MOLINA, ALEXANDER LORDS (FNP-C)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:LORDS
Last Name:MOLINA
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9442 BLUEGILL CIR
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33981-2811
Mailing Address - Country:US
Mailing Address - Phone:305-801-8886
Mailing Address - Fax:
Practice Address - Street 1:8210 SANTA CRUZ DR
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33981-5218
Practice Address - Country:US
Practice Address - Phone:786-685-5089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-02
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN000024742363LF0000X
FLAPRN11002269363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily