Healthcare Provider Details

I. General information

NPI: 1558234971
Provider Name (Legal Business Name): EDIEL PADRON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2025
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 NW 25TH ST STE 200
MIAMI FL
33122-1721
US

IV. Provider business mailing address

4950 NW 182ND ST
MIAMI GARDENS FL
33055-2921
US

V. Phone/Fax

Practice location:
  • Phone: 305-909-4872
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: