Provider Demographics
NPI:1881081958
Name:DRA. DAKMARYS PADILLA C.S.P.
Entity type:Organization
Organization Name:DRA. DAKMARYS PADILLA C.S.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAKMARYS
Authorized Official - Middle Name:
Authorized Official - Last Name:PADILLA GUZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-356-3510
Mailing Address - Street 1:PO BOX 517
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-0517
Mailing Address - Country:US
Mailing Address - Phone:787-356-3510
Mailing Address - Fax:
Practice Address - Street 1:1022 TULIPAN STREET
Practice Address - Street 2:
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627-0000
Practice Address - Country:US
Practice Address - Phone:787-356-3510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-16
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17037208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRHC986AMedicare UPIN