Healthcare Provider Details

I. General information

NPI: 1558278192
Provider Name (Legal Business Name): MR. JONATHAN DAVID PADILLA OYOLA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. #2 KM. 29.4
VEGA ALTA PR
00962
US

IV. Provider business mailing address

BO. QUEBRADA CRUZ, SECTOR EL CUATRO
TOA ALTA PR
00646-9505
US

V. Phone/Fax

Practice location:
  • Phone: 787-270-1854
  • Fax:
Mailing address:
  • Phone: 787-433-4848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number008819
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: