Healthcare Provider Details

I. General information

NPI: 1972376739
Provider Name (Legal Business Name): ROMMEL PARCE PADILLO CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2023
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3055 HAMILTON MASON RD
FAIRFIELD TWP OH
45011-5307
US

IV. Provider business mailing address

3055 HAMILTON MASON RD
FAIRFIELD TWP OH
45011-5307
US

V. Phone/Fax

Practice location:
  • Phone: 513-865-1690
  • Fax: 513-454-3053
Mailing address:
  • Phone: 513-865-1690
  • Fax: 513-454-3053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN329565
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0038134
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: