Provider Demographics
NPI:1205238656
Name:PADILLA, ROSELIA (CERTIFICATE)
Entity type:Individual
Prefix:
First Name:ROSELIA
Middle Name:
Last Name:PADILLA
Suffix:
Gender:F
Credentials:CERTIFICATE
Other - Prefix:MRS
Other - First Name:BELKIS
Other - Middle Name:
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DIPLOMA
Mailing Address - Street 1:A #26 URB BAHIA
Mailing Address - Street 2:
Mailing Address - City:GUANICA
Mailing Address - State:PR
Mailing Address - Zip Code:00653
Mailing Address - Country:US
Mailing Address - Phone:787-309-1226
Mailing Address - Fax:787-992-7011
Practice Address - Street 1:A #26 URB BAHIA
Practice Address - Street 2:
Practice Address - City:GUANICA
Practice Address - State:PR
Practice Address - Zip Code:00653
Practice Address - Country:US
Practice Address - Phone:787-309-1226
Practice Address - Fax:787-992-7011
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist