Provider Demographics
NPI:1740418854
Name:PADUANO, RALPH (LMT)
Entity Type:Individual
Prefix:MR
First Name:RALPH
Middle Name:
Last Name:PADUANO
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1202
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34451-1202
Mailing Address - Country:US
Mailing Address - Phone:352-212-8431
Mailing Address - Fax:866-519-9226
Practice Address - Street 1:2200 HIGHWAY 44 W
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34453-3873
Practice Address - Country:US
Practice Address - Phone:352-212-8431
Practice Address - Fax:866-519-9226
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-26
Last Update Date:2009-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA20998225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA20998OtherSTATE OF FL LICENSE NO.
FLC7197OtherBC/BS OF FLORIDA