Provider Demographics
NPI:1114189065
Name:PADIN, RAFAELA
Entity Type:Individual
Prefix:MRS
First Name:RAFAELA
Middle Name:
Last Name:PADIN
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:P O BOX 1670
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-1670
Mailing Address - Country:US
Mailing Address - Phone:787-796-2255
Mailing Address - Fax:787-796-2255
Practice Address - Street 1:CALLE MENDEZ VIGO # 285
Practice Address - Street 2:OFICINA B
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646
Practice Address - Country:US
Practice Address - Phone:787-796-2255
Practice Address - Fax:787-796-2255
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR231235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist