Healthcare Provider Details

I. General information

NPI: 1396012159
Provider Name (Legal Business Name): ANGEL L PADILLA CSFA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2011
Last Update Date: 04/05/2026
Certification Date: 04/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9051 SSG CHRIS FALKEL DR
HIGHLANDS RANCH CO
80129-3188
US

IV. Provider business mailing address

PO BOX 1520
EDGEWATER FL
32132-8520
US

V. Phone/Fax

Practice location:
  • Phone: 720-516-0600
  • Fax:
Mailing address:
  • Phone: 407-302-0089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: