Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | ME 54681 | FL |
NPI | 1033189196 |
---|---|
Provider Name | Manuel R Padron |
First Address | Coral Gables, FL 33145-3205 |
Second Address | Coral Gables, FL 33145-3205 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2006 |
Last Update Date | 01/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001031 | NHP (01) | FL |
14799 | BCBS (01) | FL |
248269 | AVMED (01) | FL |
370831400 | (05) | FL |
5907284 | AETNA (01) | FL |
F22961 | (02) |