Provider Demographics
NPI:1184672610
Name:PADILLA AQUINO, IVONNE (MD)
Entity Type:Individual
Prefix:
First Name:IVONNE
Middle Name:
Last Name:PADILLA AQUINO
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:VILLAS DE LA PLAYA
Mailing Address - Street 2:CALLE BOQUERON #25
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693
Mailing Address - Country:US
Mailing Address - Phone:787-795-2911
Mailing Address - Fax:787-784-0680
Practice Address - Street 1:HF16 CALLE LIZZIE GRAHAM
Practice Address - Street 2:SEPTIMA SECCION LEVITTOWN
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-3634
Practice Address - Country:US
Practice Address - Phone:787-795-2911
Practice Address - Fax:787-784-0680
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR11336207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG46610Medicare UPIN
PR0088675Medicare PIN