Provider Demographics
NPI:1518744085
Name:PADRON PALACIO, DENISSE (PTA)
Entity Type:Individual
Prefix:
First Name:DENISSE
Middle Name:
Last Name:PADRON PALACIO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 S FEDERAL HWY APT 146
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5053
Mailing Address - Country:US
Mailing Address - Phone:229-881-2594
Mailing Address - Fax:561-448-9437
Practice Address - Street 1:1405 S FEDERAL HWY APT 146
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5053
Practice Address - Country:US
Practice Address - Phone:229-881-2594
Practice Address - Fax:561-448-9437
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL31918225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant