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General NPI Number Information
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NPI Number | 1114972544
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Entity Type | Individual
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Provider Name | NIDIA CAMACHO PADILLA MD
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Gender | Female
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 410 CALLE MENDEZ VIGO SUITE 202
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City | DORADO
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State | PR
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Zip | 00646-4800
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Country | US
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Telephone | 787-278-2828
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Fax |
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Provider Business Mailing Address
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Address Line | 3013 CAMINO ALEJANDRINO SUITE 102 FONTAIN BLUE PLAZA
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City | GUAYNABO
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State | PR
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Zip | 00969-7038
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 13311
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License Number State | PR
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