MEDICARE: DR. ANTONIO C PADILLA CEDO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	17765	PR

General Provider Information

NPI Number	:	1023342409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTONIO C PADILLA CEDO M.D.

Provider Business Mailing Address
First Line	:	1 CALLE 11 APT 1609
Second Line	:	PANORAMA PLAZA
City	:	SAN JUAN
State	:	PR
Zip	:	00926-6051
Country	:	US
Telephone Number	:	787-942-8191
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 CALLE 11 APT 1609
Second Line	:	PANORAMA PLAZA
City	:	SAN JUAN
State	:	PR
Zip	:	00926-6051
Country	:	US
Telephone Number	:	787-942-8191
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2009
Last Update Date	:	02/04/2010

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