Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker |
NPI | 1003225251 |
---|---|
Provider Name | Adela Padron |
First Address | Homestead, FL 33030-4934 |
Second Address | Homestead, FL 33030-4934 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2014 |
Last Update Date | 02/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
021035600 | (05) | FL |
CBHCM100331 | FLORIDA CERTIFICATION BOARD (01) | FL |