Provider Demographics
NPI:1558098491
Name:PADAO, SHIRE MARIA (APRN)
Entity Type:Individual
Prefix:
First Name:SHIRE
Middle Name:MARIA
Last Name:PADAO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4993 SANDPIPER DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:FL
Mailing Address - Zip Code:34484-3816
Mailing Address - Country:US
Mailing Address - Phone:630-997-4455
Mailing Address - Fax:
Practice Address - Street 1:4993 SANDPIPER DR
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:FL
Practice Address - Zip Code:34484-3816
Practice Address - Country:US
Practice Address - Phone:630-997-4455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11021164363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty