Basic Information
Provider Information
NPI: 1477844652
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ORELLANA MOLINA
FirstName: ARNALDO
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4160 N ARMENIA AVE
Address2: SUITE A
City: TAMPA
State: FL
PostalCode: 336076453
CountryCode: US
TelephoneNumber: 8136738245
FaxNumber:  
Practice Location
Address1: 4160 N ARMENIA AVE
Address2: SUITE A
City: TAMPA
State: FL
PostalCode: 336076453
CountryCode: US
TelephoneNumber: 8136738245
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/22/2011
LastUpdateDate: 06/15/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208D00000XACN444FLY Allopathic & Osteopathic PhysiciansGeneral Practice 

No ID Information.


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