Healthcare Provider Details

I. General information

NPI: 1669082194
Provider Name (Legal Business Name): CINDY MARIE PADILLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2020
Last Update Date: 08/10/2020
Certification Date: 08/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S DIXIE HWY APT 537
WEST PALM BEACH FL
33401-5852
US

IV. Provider business mailing address

600 S DIXIE HWY APT 537
WEST PALM BEACH FL
33401-5852
US

V. Phone/Fax

Practice location:
  • Phone: 787-637-2355
  • Fax:
Mailing address:
  • Phone: 787-637-2355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberPS53265
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: