Provider Demographics
NPI:1265863864
Name:SEBASTIAN A PADRON MD,PA
Entity type:Organization
Organization Name:SEBASTIAN A PADRON MD,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SEBASTIAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:PADRON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-442-2228
Mailing Address - Street 1:4131 SW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2057
Mailing Address - Country:US
Mailing Address - Phone:305-442-1740
Mailing Address - Fax:305-442-2207
Practice Address - Street 1:4305 E 8TH AVE
Practice Address - Street 2:SUITE E
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-2465
Practice Address - Country:US
Practice Address - Phone:305-769-5601
Practice Address - Fax:305-769-0473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-06
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME43021261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care