Provider Demographics
NPI:1588653430
Name:NATACHA PADRINO MD PA
Entity Type:Organization
Organization Name:NATACHA PADRINO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NATACHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PADRINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD PSYCHIATRIST
Authorized Official - Phone:305-598-5558
Mailing Address - Street 1:8306 MILLS DR STE 197
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4838
Mailing Address - Country:US
Mailing Address - Phone:305-598-5558
Mailing Address - Fax:305-598-0220
Practice Address - Street 1:11775 SW 92 LN
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186
Practice Address - Country:US
Practice Address - Phone:305-598-5558
Practice Address - Fax:305-598-0220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-13
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2084P0800X
FLME770802084P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102058600Medicaid