Provider Demographics
NPI:1669744181
Name:PADRON, MIGDALIA R
Entity type:Individual
Prefix:MRS
First Name:MIGDALIA
Middle Name:R
Last Name:PADRON
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 1:400 W OBISPO AVE
Mailing Address - Street 2:
Mailing Address - City:CLEWISTON
Mailing Address - State:FL
Mailing Address - Zip Code:33440-4420
Mailing Address - Country:US
Mailing Address - Phone:863-677-0246
Mailing Address - Fax:
Practice Address - Street 1:400 W OBISPO AVE
Practice Address - Street 2:
Practice Address - City:CLEWISTON
Practice Address - State:FL
Practice Address - Zip Code:33440-4420
Practice Address - Country:US
Practice Address - Phone:863-677-0246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health