Provider Demographics
NPI:1275305526
Name:PADIN LOPEZ, ARLYN VIONETTE
Entity Type:Individual
Prefix:
First Name:ARLYN
Middle Name:VIONETTE
Last Name:PADIN LOPEZ
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 1:9725 HAMMOCKS BLVD APT 206
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-1263
Mailing Address - Country:US
Mailing Address - Phone:787-342-5944
Mailing Address - Fax:
Practice Address - Street 1:9725 HAMMOCKS BLVD APT 206
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-1263
Practice Address - Country:US
Practice Address - Phone:787-342-5944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL46041390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program