Provider Demographics
NPI:1124628607
Name:PADRON-LAYUNO, GILDA CLARA
Entity type:Individual
Prefix:
First Name:GILDA
Middle Name:CLARA
Last Name:PADRON-LAYUNO
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 1:5723 LONDONBERRIE CT
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-6968
Mailing Address - Country:US
Mailing Address - Phone:989-948-2249
Mailing Address - Fax:989-835-1286
Practice Address - Street 1:910 JOE MANN BLVD
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48642-8903
Practice Address - Country:US
Practice Address - Phone:989-835-6364
Practice Address - Fax:989-835-1984
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5315179380183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist