MEDICARE: DR. ALEXANDER PADRON MD

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	ME160938	FL
2	2084P0800X	Psychiatry Physician	ME160938	FL

General Provider Information

NPI Number	:	1346700507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEXANDER PADRON MD

Provider Business Mailing Address
First Line	:	475 SEAVIEW AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10305-3436
Country	:	US
Telephone Number	:	718-226-5976
Fax Number	:

Provider Business Practice Location Address
First Line	:	1165 W 49TH ST STE 207
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-3373
Country	:	US
Telephone Number	:	305-512-5480
Fax Number	:

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

Provider Enumeration Date	:	03/23/2019
Last Update Date	:	12/19/2024

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