Provider Demographics
NPI:1962818872
Name:MOLINA AVILA, JOSSELYN G (MD)
Entity type:Individual
Prefix:DR
First Name:JOSSELYN
Middle Name:G
Last Name:MOLINA AVILA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 149
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00977-0149
Mailing Address - Country:US
Mailing Address - Phone:787-649-5679
Mailing Address - Fax:
Practice Address - Street 1:375 AVE GENERAL VALERO STE 105
Practice Address - Street 2:
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-4894
Practice Address - Country:US
Practice Address - Phone:787-566-3099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-11
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19945207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology