Healthcare Provider Details

I. General information

NPI: 1881712313
Provider Name (Legal Business Name): LIANA PADILLA B.S,N,
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE 6 #G-8 URB. VILLA EL ENCANTO
JUANA DIAZ PR
00795
US

IV. Provider business mailing address

CALLE 6 #G-8 URB. VILLA EL ENCANTO
JUANA DIAZ PR
00795
US

V. Phone/Fax

Practice location:
  • Phone: 787-519-6444
  • Fax:
Mailing address:
  • Phone: 787-519-6444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number12456
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: