Provider Demographics
NPI:1043037187
Name:MOLINA, PEDRO JUAN (MSW)
Entity type:Individual
Prefix:
First Name:PEDRO
Middle Name:JUAN
Last Name:MOLINA
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. VILLAS DEL COQUI A56
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705
Mailing Address - Country:US
Mailing Address - Phone:787-218-2459
Mailing Address - Fax:
Practice Address - Street 1:EDIFICIO GUAYACAN CALLE JULIO CINTRON
Practice Address - Street 2:SUITE 219
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705
Practice Address - Country:US
Practice Address - Phone:939-333-4112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR138921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical