MEDICARE: DR. ERNESTO PADRON 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	207Q00000X	Family Medicine Physician	ME112144	FL

General Provider Information

NPI Number	:	1295968048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERNESTO PADRON M.D

Provider Business Mailing Address
First Line	:	4312 SW 142ND CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-4319
Country	:	US
Telephone Number	:	305-898-3611
Fax Number	:

Provider Business Practice Location Address
First Line	:	650 NW 180TH TER STE 102
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33029-2825
Country	:	US
Telephone Number	:	954-436-1212
Fax Number	:

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

Provider Enumeration Date	:	08/27/2009
Last Update Date	:	12/14/2023

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