Provider Demographics
NPI:1629647284
Name:PADRON ALFONSO, ARLENE
Entity Type:Individual
Prefix:MRS
First Name:ARLENE
Middle Name:
Last Name:PADRON ALFONSO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7330 SUNSHINE CIR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-2253
Mailing Address - Country:US
Mailing Address - Phone:813-389-5111
Mailing Address - Fax:
Practice Address - Street 1:7330 SUNSHINE CIR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-2253
Practice Address - Country:US
Practice Address - Phone:813-389-5111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-18
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11012840363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily