Provider Demographics
NPI:1992023790
Name:PADRO, MARIELA TERESA (MD)
Entity Type:Individual
Prefix:
First Name:MARIELA
Middle Name:TERESA
Last Name:PADRO
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 1:2550 S DOUGLAS RD STE 301
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-6104
Mailing Address - Country:US
Mailing Address - Phone:305-456-1014
Mailing Address - Fax:
Practice Address - Street 1:2550 S DOUGLAS RD STE 301
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-6104
Practice Address - Country:US
Practice Address - Phone:305-456-1014
Practice Address - Fax:786-408-5669
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-04
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1212222084P0800X
NY2604952084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry