Provider Demographics
NPI:1346293446
Name:PADILLA, TERESA VERONICA (PT)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:VERONICA
Last Name:PADILLA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W21 CALLE CERRILLOS
Mailing Address - Street 2:COLINAS METROPOLITANAS
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5239
Mailing Address - Country:US
Mailing Address - Phone:787-403-7374
Mailing Address - Fax:
Practice Address - Street 1:W21 CALLE CERRILLOS
Practice Address - Street 2:COLINAS METROPOLITANAS
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-5239
Practice Address - Country:US
Practice Address - Phone:787-403-7374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR895225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR50069Medicare ID - Type UnspecifiedPROVIDER NUMBER
PRP64841Medicare UPIN