Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 17765 | PR |
NPI | 1023342409 |
---|---|
Provider Name | Dr. Antonio C Padilla Cedo |
First Address | San Juan, PR 00926-6051 |
Second Address | San Juan, PR 00926-6051 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2009 |
Last Update Date | 04/02/2010 |