Provider Demographics
NPI:1073234571
Name:PADRON, GISELA
Entity Type:Individual
Prefix:
First Name:GISELA
Middle Name:
Last Name:PADRON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6952 SW 39TH ST APT C304
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-2447
Mailing Address - Country:US
Mailing Address - Phone:305-310-8315
Mailing Address - Fax:
Practice Address - Street 1:7325 SW 63RD AVE STE 101
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4812
Practice Address - Country:US
Practice Address - Phone:305-204-8818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-05
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist