Provider Demographics
NPI:1013961705
Name:PADRON, CELIA Z (MD)
Entity Type:Individual
Prefix:DR
First Name:CELIA
Middle Name:Z
Last Name:PADRON
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 1:7930 NW 36TH ST STE 215
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6677
Mailing Address - Country:US
Mailing Address - Phone:856-596-6333
Mailing Address - Fax:856-596-6655
Practice Address - Street 1:7930 NW 36TH ST STE 215
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6677
Practice Address - Country:US
Practice Address - Phone:305-587-2408
Practice Address - Fax:877-347-5666
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME129459208000000X
NJ25MA05448300174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020654200Medicaid