Healthcare Provider Details

I. General information

NPI: 1265947071
Provider Name (Legal Business Name): JPAD GROUP CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2017
Last Update Date: 12/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 NW 183RD ST STE 239B5
MIAMI GARDENS FL
33169-4502
US

IV. Provider business mailing address

99 NW 183RD ST STE 239B5
MIAMI GARDENS FL
33169-4502
US

V. Phone/Fax

Practice location:
  • Phone: 786-233-2321
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN G PADRON
Title or Position: PRESIDENT
Credential:
Phone: 786-233-2321