MEDICARE: DR. JOSE D PADRON CARMONA 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	207R00000X	Internal Medicine Physician	16453	PR

General Provider Information

NPI Number	:	1598985251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE D PADRON CARMONA M.D.

Provider Business Mailing Address
First Line	:	917 AVE TITO CASTRO
Second Line	:	TORRE MEDICA SAN LUCAS SUITE 613
City	:	PONCE
State	:	PR
Zip	:	00716-4722
Country	:	US
Telephone Number	:	787-651-1426
Fax Number	:	787-913-0104

Provider Business Practice Location Address
First Line	:	917 AVE TITO CASTRO
Second Line	:	TORRE MEDICA SAN LUCAS SUITE 613
City	:	PONCE
State	:	PR
Zip	:	00716-4722
Country	:	US
Telephone Number	:	787-651-1426
Fax Number	:	787-913-0104

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

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	06/22/2023

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