Provider Demographics
NPI:1114816147
Name:PADILLA RODRIGUEZ, CARLOS MANUEL
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:MANUEL
Last Name:PADILLA RODRIGUEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13025 CORDELIA LN UNIT 309
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32824-5172
Mailing Address - Country:US
Mailing Address - Phone:787-429-3535
Mailing Address - Fax:
Practice Address - Street 1:1078 CYPRESS PKWY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-3328
Practice Address - Country:US
Practice Address - Phone:407-624-5808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH15551111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor