Provider Demographics
NPI:1821066143
Name:LADINES, CECILIA AMAN (MD)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:AMAN
Last Name:LADINES
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 1:700 8TH AVE W
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-4737
Mailing Address - Country:US
Mailing Address - Phone:941-776-4008
Mailing Address - Fax:941-845-4963
Practice Address - Street 1:6040 STATE ROAD 70 E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-9720
Practice Address - Country:US
Practice Address - Phone:941-366-2273
Practice Address - Fax:941-953-6500
Is Sole Proprietor?:No
Enumeration Date:2006-03-11
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME76277208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL254932800Medicaid
I236247Medicare UPIN
FL254932800Medicaid