Provider Demographics
NPI:1508844697
Name:BADILLO, FELIX L (MD)
Entity Type:Individual
Prefix:
First Name:FELIX
Middle Name:L
Last Name:BADILLO
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 1:101 HALF MOON CIR APT B
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-8522
Mailing Address - Country:US
Mailing Address - Phone:516-967-2551
Mailing Address - Fax:
Practice Address - Street 1:101 HALF MOON CIR APT B
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-8522
Practice Address - Country:US
Practice Address - Phone:516-967-2551
Practice Address - Fax:516-627-9397
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY149474-1208800000X
FLME163079208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY89A071Medicare ID - Type Unspecified
NYA64651Medicare UPIN