MEDICARE: MRS. MARTHA ELIZABETH PADILLA ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	1651912	FL

General Provider Information

NPI Number	:	1083709273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARTHA ELIZABETH PADILLA ARNP

Provider Business Mailing Address
First Line	:	365 GRAND CONCOURSE
Second Line	:
City	:	MIAMI SHORES
State	:	FL
Zip	:	33138-4276
Country	:	US
Telephone Number	:	305-759-8532
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 NW 16TH STREET,
Second Line	:	112
City	:	MIAMI
State	:	FL
Zip	:	33125-0000
Country	:	US
Telephone Number	:	305-575-7000
Fax Number	:	305-575-3255

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	07/08/2007

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