Provider Demographics
NPI:1124506506
Name:PADRO, RAFAEL A (AP, DOM, LAC)
Entity type:Individual
Prefix:
First Name:RAFAEL
Middle Name:A
Last Name:PADRO
Suffix:
Gender:M
Credentials:AP, DOM, LAC
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:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-30
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3974171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty