Healthcare Provider Details

I. General information

NPI: 1336947142
Provider Name (Legal Business Name): MARIA DE LOS ANGELES PADRINO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2025
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9240 SUNSET DR STE 202
MIAMI FL
33173-3263
US

IV. Provider business mailing address

579 RACQUET CLUB RD APT 9
WESTON FL
33326-1875
US

V. Phone/Fax

Practice location:
  • Phone: 305-280-5730
  • Fax:
Mailing address:
  • Phone: 954-864-9359
  • Fax: 954-577-7780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: