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General NPI Number Information
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NPI Number | 1538165691
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Entity Type | Individual
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Provider Name | ANTONIO PADILLA FELIZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/23/2005
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Last Update Date | 06/05/2020
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Provider Practice Location Address
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Address Line | 1925 E ORMAN AVE STE A340
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City | PUEBLO
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State | CO
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Zip | 81004-3571
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Country | US
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Telephone | 719-569-7400
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Fax | 719-569-7338
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Provider Business Mailing Address
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Address Line | 3510 SAN JOSE CT
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City | PUEBLO
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State | CO
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Zip | 81005-3916
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Country | US
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Telephone | 719-545-9713
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Fax | 719-545-2054
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 37048
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 37048
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License Number State | CO
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