Provider Demographics
NPI:1932179157
Name:PADILLA, SOFIA (MD)
Entity Type:Individual
Prefix:
First Name:SOFIA
Middle Name:
Last Name:PADILLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SOFIA
Other - Middle Name:AESCHLIMAN
Other - Last Name:PADILLA-BAFALLUY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 6450
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-6450
Mailing Address - Country:US
Mailing Address - Phone:787-805-1818
Mailing Address - Fax:787-832-1585
Practice Address - Street 1:HOSPITAL BELLA VISTA
Practice Address - Street 2:CARR 349 KM 2.7 CERRO LAS MESAS
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-834-6000
Practice Address - Fax:787-832-1585
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4779207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
067029OtherLA CRUZ AZUL DE PR
95913OtherSSS
6605753523OtherMEDICAL CARD SYSTEMS HMO
2458BOtherPREFERRED MEDICARE CHOICE
PR0095913Medicaid
6605753523OtherMCS CLASSIC CARE
601075OtherMEDICARE MUCHO MAS
95913OtherMEDICARE OPTIMA
PR6605753523OtherMEDICAL CARD SYSTEMS INC
067029OtherLA CRUZ AZUL DE PR