Provider Demographics
NPI:1760003610
Name:PADRON, SIMONETTE ANDREA (DO)
Entity type:Individual
Prefix:
First Name:SIMONETTE
Middle Name:ANDREA
Last Name:PADRON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11185 NW 72ND TER
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-3669
Mailing Address - Country:US
Mailing Address - Phone:786-282-8628
Mailing Address - Fax:
Practice Address - Street 1:11185 NW 72ND TER
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-3669
Practice Address - Country:US
Practice Address - Phone:786-282-8628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-01
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLOS21801207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program