Provider Demographics
NPI:1205211653
Name:PADILLA, CARMAYRA
Entity Type:Individual
Prefix:
First Name:CARMAYRA
Middle Name:
Last Name:PADILLA
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:URB JARD MONACO I C/ MANUEL JIMENEZ # D3
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR - PUERTO RICO
Mailing Address - Zip Code:00674
Mailing Address - Country:UM
Mailing Address - Phone:787-346-3116
Mailing Address - Fax:
Practice Address - Street 1:URB JARD MONACO I C/ MANUEL JIMENEZ # D3
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00674
Practice Address - Country:UM
Practice Address - Phone:787-346-3116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-28
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR129221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical