Healthcare Provider Details

I. General information

NPI: 1730950254
Provider Name (Legal Business Name): FRANCISCO ANTONIO PADILLA MS. RDN. CSSD.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2024
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8085 S CHESTER ST
CENTENNIAL CO
80112-3543
US

IV. Provider business mailing address

834 S JOPLIN CIR
AURORA CO
80017-3068
US

V. Phone/Fax

Practice location:
  • Phone: 720-255-9470
  • Fax:
Mailing address:
  • Phone: 720-255-9470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86148609
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code133VN1501X
TaxonomySports Dietetics Nutrition Registered Dietitian
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: