Provider Demographics
NPI:1740388164
Name:PADILLA RODRIGUEZ, MARIA DEL C (MD)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:DEL C
Last Name:PADILLA RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 TORRE SAN CRISTOBAL
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-2847
Mailing Address - Country:US
Mailing Address - Phone:787-848-5194
Mailing Address - Fax:787-848-5194
Practice Address - Street 1:206 TORRE SAN CRISTOBAL
Practice Address - Street 2:
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780-2847
Practice Address - Country:US
Practice Address - Phone:787-848-5194
Practice Address - Fax:787-848-5194
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8152207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRD34221Medicare UPIN
PR29867Medicare ID - Type Unspecified