Healthcare Provider Details

I. General information

NPI: 1376737643
Provider Name (Legal Business Name): JOSEPH M PADENI AU.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2007
Last Update Date: 03/30/2022
Certification Date: 03/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 5TH AVE N SUITE 304
ST PETERSBURG FL
33705-1400
US

IV. Provider business mailing address

1201 5TH AVE N STE 304
ST PETERSBURG FL
33705-1425
US

V. Phone/Fax

Practice location:
  • Phone: 727-820-7708
  • Fax: 727-820-7768
Mailing address:
  • Phone: 727-820-7708
  • Fax: 727-820-7768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY802
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: