Provider Demographics
NPI:1093874174
Name:PAREDES, MADELYN (MD)
Entity Type:Individual
Prefix:
First Name:MADELYN
Middle Name:
Last Name:PAREDES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3015 S CONGRESS AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-2111
Mailing Address - Country:US
Mailing Address - Phone:561-838-7785
Mailing Address - Fax:561-631-8513
Practice Address - Street 1:3015 S CONGRESS AVE STE 4
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-2111
Practice Address - Country:US
Practice Address - Phone:561-838-7785
Practice Address - Fax:561-631-8513
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98317207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL31067OtherBCBS