MEDICARE: KATHERINE MARIE PADILLA-RODRIGUEZ 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	2084N0400X	Neurology Physician	17,907	PR
2	2084N0600X	Clinical Neurophysiology Physician	17907	PR

General Provider Information

NPI Number	:	1962601633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE MARIE PADILLA-RODRIGUEZ M.D.

Provider Business Mailing Address
First Line	:	DA-3 CALLE HASTINGS
Second Line	:	GARDEN HILLS NORTE
City	:	GUAYNABO
State	:	PR
Zip	:	00966-2128
Country	:	US
Telephone Number	:	787-653-5060
Fax Number	:	787-653-9880

Provider Business Practice Location Address
First Line	:	30 CALLE PADIAL STE 120
Second Line	:
City	:	CAGUAS
State	:	PR
Zip	:	00725-3842
Country	:	US
Telephone Number	:	787-653-5060
Fax Number	:	787-653-9880

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

Provider Enumeration Date	:	07/13/2007
Last Update Date	:	07/30/2020

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