Healthcare Provider Details

I. General information

NPI: 1265863864
Provider Name (Legal Business Name): SEBASTIAN A PADRON MD,PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2013
Last Update Date: 12/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4305 E 8TH AVE SUITE E
HIALEAH FL
33013-2465
US

IV. Provider business mailing address

4131 SW 6TH ST
CORAL GABLES FL
33134-2057
US

V. Phone/Fax

Practice location:
  • Phone: 305-769-5601
  • Fax: 305-769-0473
Mailing address:
  • Phone: 305-442-1740
  • Fax: 305-442-2207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberME43021
License Number StateFL

VIII. Authorized Official

Name: MR. SEBASTIAN A PADRON
Title or Position: OWNER
Credential: MD
Phone: 305-442-2228