MEDICARE: DR. WILLMA L PADRO M.D.

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	208D00000X	General Practice Physician	ACN 345	FL
2	208D00000X	General Practice Physician	16962	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184935900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLMA L PADRO M.D.

Provider Business Mailing Address
First Line	:	6675 WESTWOOD BLVD
Second Line	:	STE 475
City	:	ORLANDO
State	:	FL
Zip	:	32821-6027
Country	:	US
Telephone Number	:	407-845-0330
Fax Number	:	888-972-1752

Provider Business Practice Location Address
First Line	:	1130 S SEMORAN BLVD
Second Line	:	STE. B
City	:	ORLANDO
State	:	FL
Zip	:	32807-1457
Country	:	US
Telephone Number	:	650-279-9703
Fax Number	:

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

Provider Enumeration Date	:	06/25/2010
Last Update Date	:	04/09/2021

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