Healthcare Provider Details

I. General information

NPI: 1023081114
Provider Name (Legal Business Name): MIGUEL A. PALADINES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 12/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVENIDA ROBERTO CLEMENTE C-11 BLQ 33-2
CAROLINA PR
00985
US

IV. Provider business mailing address

PLAZA CAROLINA STATION PO BOX 9512
CAROLINA PR
00988-9512
US

V. Phone/Fax

Practice location:
  • Phone: 787-769-1630
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number14749
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: