Provider Demographics
NPI:1124211735
Name:PADRO, RAFAEL E (PHD)
Entity Type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:E
Last Name:PADRO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 CARR 2
Mailing Address - Street 2:VILLA CAPARRA
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-1915
Mailing Address - Country:US
Mailing Address - Phone:787-792-8383
Mailing Address - Fax:787-792-8778
Practice Address - Street 1:239 CARR 2
Practice Address - Street 2:VILLA CAPARRA
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966-1915
Practice Address - Country:US
Practice Address - Phone:787-792-8383
Practice Address - Fax:787-792-8778
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-27
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR709261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health