Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | 5702 | WI |
Y | 2084N0400X | Neurologist | 66814 | WI |
N | 2084N0402X | Child Neurologist | 66814 | WI |
NPI | 1033505821 |
---|---|
Provider Name | Heydi Flores Podadera |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53705-3233 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2015 |
Last Update Date | 16/07/2020 |