Provider Demographics
NPI:1346291077
Name:PADRON, ERNESTO ROGELIO (MD,)
Entity Type:Individual
Prefix:
First Name:ERNESTO
Middle Name:ROGELIO
Last Name:PADRON
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3213 S. 24TH STREET, SUITE 101-B
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68108-1825
Mailing Address - Country:US
Mailing Address - Phone:402-933-8375
Mailing Address - Fax:402-933-9964
Practice Address - Street 1:3213 S. 24TH STREET, SUITE 101-B
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68108-1825
Practice Address - Country:US
Practice Address - Phone:402-933-8375
Practice Address - Fax:402-933-9964
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036111230207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine