Provider Demographics
NPI:1568454395
Name:MOLINA, MIGUEL FRANCISCO (MD)
Entity type:Individual
Prefix:
First Name:MIGUEL
Middle Name:FRANCISCO
Last Name:MOLINA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4409 UTICA ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-6530
Mailing Address - Country:US
Mailing Address - Phone:504-457-3687
Mailing Address - Fax:504-620-0250
Practice Address - Street 1:1111 MEDICAL CENTER BLVD
Practice Address - Street 2:SUITE N511
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-3151
Practice Address - Country:US
Practice Address - Phone:504-349-6301
Practice Address - Fax:504-349-6308
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA12172R207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1946095Medicaid
LA5237276OtherCIGNA PROVIDER #
LA1697630Medicaid
LA2000838OtherAETNA PROVIDER #
LA5237276OtherCIGNA PROVIDER #
LA5F615Medicare ID - Type UnspecifiedGROUP MEDICARE #
LAG47831Medicare UPIN