Healthcare Provider Details

I. General information

NPI: 1386749596
Provider Name (Legal Business Name): SEBASTIAN A PADRON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 11/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4141 SW 6TH ST
CORAL GABLES FL
33134-2057
US

IV. Provider business mailing address

4141 SW 6TH ST
CORAL GABLES FL
33134-2057
US

V. Phone/Fax

Practice location:
  • Phone: 305-443-5031
  • Fax: 305-442-0844
Mailing address:
  • Phone: 305-443-5031
  • Fax: 305-442-0844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME43021
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: