Healthcare Provider Details

I. General information

NPI: 1588653430
Provider Name (Legal Business Name): NATACHA PADRINO MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2005
Last Update Date: 01/19/2022
Certification Date: 01/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11775 SW 92 LN
MIAMI FL
33186
US

IV. Provider business mailing address

8306 MILLS DR STE 197
MIAMI FL
33183-4838
US

V. Phone/Fax

Practice location:
  • Phone: 305-598-5558
  • Fax: 305-598-0220
Mailing address:
  • Phone: 305-598-5558
  • Fax: 305-598-0220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License NumberME77080
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: NATACHA PADRINO
Title or Position: PRESIDENT
Credential: MD PSYCHIATRIST
Phone: 305-598-5558