Provider Demographics
NPI:1760653414
Name:PADILLA, AMARILYS A
Entity Type:Individual
Prefix:
First Name:AMARILYS
Middle Name:A
Last Name:PADILLA
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 1:21 CALLE LA CRUZ
Mailing Address - Street 2:
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795-2408
Mailing Address - Country:US
Mailing Address - Phone:787-260-0019
Mailing Address - Fax:787-260-0019
Practice Address - Street 1:21 CALLE LA CRUZ
Practice Address - Street 2:
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795-2408
Practice Address - Country:US
Practice Address - Phone:787-601-5331
Practice Address - Fax:787-260-0019
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-20
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR994225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist